Evaluation of frailty and sarcopenia in patients undergoing elective surgery over 65 years of age, prospective-observational study

Evaluation of Frailty and Sarcopenia in Patients Undergoing Elective Surgery Over 65 Years of Age, Prospective-Observational Study Objective: In our study, we aimed to evaluate patients aged 65 years and older who underwent elective surgical surgery in the Department of Anesthesiology and Reanimation of Çukurova University Faculty of Medicine in terms of frailty and sarcopenia preoperatively and to examine the complications that developed during and after the operation. Material and Method: Our study included 276 patients aged 65 years and older who underwent elective surgery at Çukurova University Faculty of Medicine between November 2021 and May 2022. Demographic data of the patients, the operation performed and the cause, concomitant diseases, surgical risk class, marital status, income level, education level were recorded. Patients were scored in terms of frailty index. Again, rectus femoris muscle was measured by evaluating all patients for sarcopenia in B mode (with linear high-frequency probe) with Esaote, MyLabtmSix ultrasound in the preoperative care unit. In all patients, both the thickness and crosssectional area of the rectus femoris muscle were measured. Results: Data of 276 patients were evaluated. The mean age of the patients included in the study was 71.5±5.99 years. 58% of the patients were identified as male gender. According to the surgical risk classification, 47.5% of the patients were found to be in the low, 47.8% were in the medium risk class, and 4.7% were in the high risk class. 35.5% of the patients according to the cross-sectional area; 32.2% according to rectus femoris thickness; In 25.4% of the patients, sarcopenia was detected according to both cross-sectional area and rectus femoris thickness. While fragility was detected in 54.7% of the patients; 74.2% of the patients with frailty were found to be pre-fragile, 25.8% were found to be fragile. It was determined that 176 of the patients developed perioperative complications. Postoperative complications were detected in 115 of the patients. The mean age of the patients who developed sarcopenia was higher (p<0.001). The development of sarcopenia was found to be statistically significantly more common in patients with low education level, patients with low income level, and patients living alone (p<0.001). The development of sarcopenia was statistically higher in those with medium and high surgical risk (p=0.004). The mean length of hospital stay was also statistically significantly higher in patients who developed sarcopenia (p<0.001). Peroperative complication development rate was found to be statistically higher in patients with sarcopenia (p<0.001). The rate of postoperative complication development was statistically higher in sarcopenic patients (p<0.001). The presence of perioperative and postoperative complications was observed more frequently in patients with high and medium risk surgical risk classes (p<0.001; p<0.001, respectively). The presence of perioperative and postoperative complications was statistically significantly higher in patients in the fragile group (p=0.001; p=0.001, respectively). The mean length of intensive care unit stay and hospital stay in patients in the fragil group was statistically significantly higher than in patients in the pre-fragile group (p<0.001). Conclusion: As a result of the study, perioperative and postoperative complications were observed at a much higher rate in frail and sarcopenic patients and were found to be statistically significant. In this study, it was revealed that investigating frailty and sarcopenia in patients over 65 years of age in the evaluation of the risk of perioperative and postoperative complications is very important in terms of preventing complications and making necessary preparations. Key Words: Sarcopenia, Frailty, Geriatric Patient, Complication