| ORIGINAL ARTICLE |
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| Year : 2016 | Volume
: 60
| Issue : 2 | Page : 102-107 |
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Association between frailty, cerebral oxygenation and adverse post-operative outcomes in elderly patients undergoing non-cardiac surgery: An observational pilot study
Shariq Ali Khan1, Henry Wenjie Chua1, Premila Hirubalan1, Ranjith Baskar Karthekeyan2, Harikrishnan Kothandan1
1 Department of Anaesthesiology, General Hospital, Singapore
2 Department of Anaesthesiology, Sri Ramachandra Medical College and Research Institute, Chennai, Tamil Nadu, India
Correspondence Address:
Harikrishnan Kothandan
Department of Anaesthesiology, Block 6 Level 2, Singapore General Hospital, Singapore 169608. National Heart Centre
Singapore
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/0019-5049.176278
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Background and Aims: Although both frailty and low cerebral oxygen saturation increase the risk of post-operative complications, their relationship is yet to be investigated. The purpose of this observational study was to investigate the association between frailty, intraoperative cerebral oxygen saturation and post-operative complications in elderly patients undergoing non-cardiac surgery. Methods: After approval from the Institutional Review Board, 25 elderly patients (>65 years) undergoing non-cardiac major surgery were included in this study. Pre-operatively, all included patients were assessed for frailty and classified into frail and non-frail groups. All patients had routine intraoperative monitors, and a cerebral oximeter applied during anaesthesia. The 'intraoperative' anaesthesiologist and the post-operative study investigator were blinded to cerebral oximeter readings throughout the study. The incidence of significant intraoperative cerebral oxygen desaturation, adverse post-operative outcomes and length of hospital stay were compared. Statistical significance was defined as a value of P < 0.05. Results: We found that the frail group had more intraoperative cerebral desaturation (odds ratio [OR] [95% confidence interval [CI]]: 1.75 [1.11–2.75]) and longer median (interquartile range) length of hospital stay compared to the non-frail group (13.5 days [8.75–27.5] and 8 days [6–11], respectively). Furthermore, in patients with a low-baseline cerebral oxygen saturation (<55%), intraoperative cerebral desaturation (OR [95% CI]: 2.10 [1.00–4.42]), adverse post-operative outcomes (OR [95% CI]: 1.80 [1.00–3.23]) and median (interquartile range) length of hospital stay (15 days [9–31.5] vs. 9 days [6.25–13.75], P = 0.04) were significantly higher compared to subjects with higher baseline (≥55%) cerebral oxygen saturation. Conclusions: Frail patients have more intraoperative cerebral desaturation and longer lengths of hospital stay compared to non-frail patients. |
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