Frailty (Again, Sorry)!

Angie SzumlinskiStudies

Although we have posted many blog articles on the issue of Frailty, this study caught my eye because frailty is becoming more and more a concern for our residents! How many of your residents in the past year required emergency general surgery? What exactly is emergency general surgery? According to a study published in the Journal of the American Geriatrics Society, it can be anything from bowel perforation repair, bleeding ulcers, adhesions, etc. when a resident presents in the ER with little time to medically optimize their frailty before treatment. That’s right, we already knew that, when a resident becomes ill it is usually pretty quick and transfer for treatment needs to occur immediately. Even in the best scenarios, it takes time to get the resident to the ER which adds to the time constraints the medical team is under. The resident may be experiencing pain, they may be unresponsive, they may be combative, any and all of the above. During this time, the ER team is required to assess to determine what could be happening to the resident. In honesty, frailty probably isn’t at the top of their worry list. So, surgical interventions are initiated if necessary and the outcomes are not great. Older emergency general surgery patients with frailty are at increased risk for poor 1-year outcomes. All the more reason it is important to have your residents assessed for their level of frailty and include this information on transfer sheets for the medical team at the ER to be aware. Will it change the outcome? Maybe not because if surgery is required it is going to happen but at a minimum, it will give the team vital information regarding what to expect outcome wise for each individual patient. To read the study in its entirety, click here.