One-Minute Frailty Test Determines Likelihood of Post-Surgical Complications

A one-minute test can determine how likely a patient is to have post-surgical complications, according to an article in the Journal of the American College of Surgeons.

Researchers from Emory University School of Medicine in Atlanta completed a 5 step assessment on 351 patients aged 18 years or older who had been admitted to medical centers for major abdominal, urologic, or gastrointestinal operations in order to find a better way to assess frailty. Frailty, the researchers explained, is not always associated with old age and it is important to assess for an easier post operation recovery process. According to a press release, the test included the following criteria:

• Shrinking: Self-reported unintentional weight loss of more than 10 pounds in the last year
• Grip Strength: Measured by having the patient squeeze a hand-held dynamometer adjusted for gender and body mass index (BMI)
• Exhaustion: Measured by responses to questions about effort and motivation
• Low Activity: Ascertained by inquiring about leisure time activities
• Slowed Walking Speed: Measured by the speed at which a patient walks 15 feet adjusted by gender and height

The researchers noted that measuring frailty is often overlooked because of time it takes (typically about 10 minutes) or that it requires a trained professional; however, this test makes it easier on practices. It’s done in about 1 minute and can be conducted by anyone who has an interaction with the patient. About a third of patients in the study (36.7 percent) experienced complications within 30 days following a surgery — 24.5 percent experienced minor complications and 14.2 percent experienced major complications.

The researchers determined that grip strength and involuntary weight loss were the 2 strongest predictors of post surgical complications. Using those 2 steps were as accurate as the full 5 step test, they said.

“This step is important for setting expectations for the patient and the family,” study co author Kenneth Ogan, MD, explained in the press release. “If a patient is found to be frail prior to surgery, it is critical that the patient is aware that their risk of a postoperative complication is increased. Our data is clear: If you have a weak grip and you’re losing weight, you’re at risk. We want to be better prepared for any risks after the operation.”

Previous research has shown that exercise can avoid frailty in older adults, though the authors of this study note that frailty is not limited to elderly patients.