Senior adults fear postoperative loss of independence the most, and this might represent an additional burden for families and society. The number of geriatric patients admitted to the emergency room requiring an urgent surgical treatment is rising, and the presence of frailty is the main risk factor for postoperative morbidity and functional decline. Frailty assessment in the busy emergency setting is challenging. The aim of this study is to verify the effectiveness of a very simple five-item frailty screening tool, the Flemish version of the Triage Risk Screening Tool (fTRST), in predicting functional loss after emergency surgery among senior adults who were found to be independent before surgery. All consecutive individuals aged 70 years and older who were independent (activity of daily living (ADL) score ≥5) and were admitted to the emergency surgery unit with an urgent need for abdominal surgery between December 2015 and May 2016 were prospectively included in the study. On admission, individuals were screened using the fTRST and additional metrics such as the age-adjusted Charlson Comorbidity Index (CACI) and the ASA score. Thirty- and 90-day complications and postoperative decline in the ADL score where recorded. Regression analysis was performed to identify preoperative predictors of functional loss. Seventy-eight patients entered the study. Thirty-day mortality rate was 12.8% (10/78), and the 90-day overall mortality was 15.4% (12/78). One in every four patients (17/68) experienced a significant functional loss at 30-day follow-up. At 90-day follow-up, only 3/17 patients recovered, 2 patients died, and 12 remained permanently dependent. On the regression analysis, a statistically significant correlation with functional loss was found for fTRST, CACI, and age≥85 years old both at 30 and 90 days after surgery. fTRST≥2 showed the highest effectiveness in predicting functional loss at 90 days with AUC 72 and OR 6.93 (95% CI 1.71–28.05). The institutionalization rate with the need to discharge patients to a healthcare facility was 7.6% (5/66); all of them had a fTRST≥2. fTRST is an easy and effective tool to predict the risk of a postoperative functional decline and nursing home admission in the emergency setting.

中文翻译：

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使用简单的虚弱筛查工具可以预测急诊手术中的功能丧失

老年人最担心术后失去独立性，这可能会给家庭和社会带来额外的负担。急诊室接受紧急手术治疗的老年患者数量不断增加，虚弱是术后发病率和功能下降的主要危险因素。在繁忙的紧急情况下进行虚弱评估具有挑战性。本研究的目的是验证一个非常简单的五项虚弱筛查工具的有效性，佛兰德版的分流风险筛查工具 (fTRST)，在预测被发现独立的老年人急诊手术后功能丧失方面的有效性手术前。本研究前瞻性地纳入了所有 70 岁及以上的独立个体（日常生活活动（ADL）评分≥5）并在 2015 年 12 月至 2016 年 5 月期间因急需进行腹部手术而入住急诊手术室的所有连续个体. 入院时，使用 fTRST 和其他指标（如年龄调整的查尔森合并症指数 (CACI) 和 ASA 评分）对个人进行筛查。记录了 30 天和 90 天并发症和术后 ADL 评分下降。进行回归分析以确定术前功能丧失的预测因素。七十八名患者进入了研究。30天死亡率为12.8%（10/78），90天总死亡率为15.4%（12/78）。在 30 天的随访中，四分之一的患者 (17/68) 经历了显着的功能丧失。在 90 天的随访中，只有 3/17 名患者康复，2 名患者死亡，12 名患者仍然永久依赖。在回归分析中，fTRST、CACI 和年龄≥85 岁在术后 30 天和 90 天都与功能丧失存在统计学显着相关性。fTRST≥2 在预测 90 天功能丧失方面的有效性最高，AUC 为 72，OR 为 6.93（95% CI 1.71–28.05）。需要将患者送往医疗机构的住院率为 7.6% (5/66)；他们都有一个fTRST≥2。fTRST 是一种简单有效的工具，可用于预测紧急情况下术后功能下降和入住疗养院的风险。术后 30 天和 90 天发现 fTRST、CACI 和年龄≥85 岁与功能丧失具有统计学显着相关性。fTRST≥2 在预测 90 天功能丧失方面的有效性最高，AUC 为 72，OR 为 6.93（95% CI 1.71–28.05）。需要将患者送往医疗机构的住院率为 7.6% (5/66)；他们都有一个fTRST≥2。fTRST 是一种简单有效的工具，可用于预测紧急情况下术后功能下降和入住疗养院的风险。术后 30 天和 90 天发现 fTRST、CACI 和年龄≥85 岁与功能丧失具有统计学显着相关性。fTRST≥2 在预测 90 天功能丧失方面的有效性最高，AUC 为 72，OR 为 6.93（95% CI 1.71–28.05）。需要将患者送往医疗机构的住院率为 7.6% (5/66)；他们都有一个fTRST≥2。fTRST 是一种简单有效的工具，可用于预测紧急情况下术后功能下降和入住疗养院的风险。需要将患者送往医疗机构的住院率为 7.6% (5/66)；他们都有一个fTRST≥2。fTRST 是一种简单有效的工具，可用于预测紧急情况下术后功能下降和入住疗养院的风险。需要将患者送往医疗机构的住院率为 7.6% (5/66)；他们都有一个fTRST≥2。fTRST 是一种简单有效的工具，可用于预测紧急情况下术后功能下降和入住疗养院的风险。