Decision-making for Postoperative Care in Geriatric Patients Undergoing Minor Surgeries using Mini Mental State Examination, Barthel Index of Activities of Daily Living and CSHA-Clinical Frailty Scale

OpenAlex İngilizce

Purpose: The prediction of postoperative outcome following major surgeries in elderly patients requires a decision-making process, which was suggested to be constructed on data pertaining to the cognitive function, functional status and frailty. We aimed to evaluate their predictive value for minor surgeries. Material and Methods: Patients, ≥65 years of age with ASA 1-3, scheduled for elective minor surgeries between January-June 2019 were enrolled. MMSE, Barthel Index (BI) of ADL and CSHA-CFS were used to evaluate the cognitive function, functional status and frailty on admission, respectively. The MMSE cut-off point was 24 and the frailty cut-off point was 4. The relationships of these parameters with postoperative status either as outpatient or inpatient, PACU stay, LOS in hospital and readmission within 30 days were evaluated. Results: Ninety-nine patients were included. The MMSE scores, BIs and CSHA-CFS scores were similar in all groups. The number of inpatients were higher among patients either with MMSE 2 (n=20 (83.3%)) (p=0.023). The patients with ASA>2 had higher probability of length of stay >1 day (p=0.036) and for PACU stay (p=0.042) irrespective of frailty score. There was no correlation with readmission within 30 days. Conclusion: ASA>2 was correlated with inpatient status when associated with MMSE1 day in the elderly after minor surgeries. CSHA-CFS ≥4 was also correlated with inpatient status independently.