Postoperative Frailty Trajectories and One-Year Mortality in Older Surgical Patients

Chinese PLA General Hospital (301 Hospital)

Status: Completed

Conditions: Frailty in Older Adults; Trajectory; All Cause Mortality

Study type: Observational

Funder types: Other

Identifiers

NCT07322809

PLAGH - FRAIL Trajectory

Details and patient eligibility

About

Frailty is a key predictor of adverse outcomes in older surgical patients, yet its longitudinal evolution and potentially reversible nature remain underexplored in perioperative settings. This study aimed to characterize postoperative frailty trajectories in older patients and to examine their association with one-year mortality, as well as factors influencing trajectory group.

Enrollment: 4,417 patients

Sex: All

Ages: 65+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Aged ≥65 years;
• Underwent elective non-cardiac, non-neurosurgical procedures;
• Completed standardized frailty assessments both preoperatively and postoperatively.

Exclusion criteria

• Severe dementia, language disorders, significant hearing or visual impairments, or coma;
• Cognitive function below the Mini-Mental State Examination (MMSE) thresholds (<18 for illiterate individuals, <21 for individuals with primary education, and <25 for individuals with secondary education or higher);
• Surgery performed under local anesthesia or monitored anesthesia care;
• Surgical duration ≤30 minutes;
• Missing data on postoperative complications or one-year mortality required for this study;
• Incomplete frailty assessments at 1, 3, and 6 months after surgery.

Trial design

4,417 participants in 1 patient group

A retrospective cohort study based on prospectively collected data.

Description:

Patients' frailty was assessed using the FRAIL scale at four time points: preoperatively and at 1, 3, and 6 months postoperatively. Patients were classified into distinct frailty trajectory groups using latent class trajectory modeling. The study examined the associations between frailty trajectories and one-year mortality and further identified independent factors associated with frailty trajectory membership.