The effect of frailty score on recovery time from anaesthesia in geriatric patients undergoing elective surgery

The geriatric patient population requiring surgical procedures is steadily increasing. Frailty in geriatric patients is defined as a decline in functional capacity, cognitive functions, physical capacity, and daily living activities associated with aging. Our study aimed to investigate the effect of frailty scores on recovery time from general anesthesia in geriatric patients undergoing elective surgical interventions. After obtaining approval from the Fırat University Non-Interventional Research Ethics Committee, patients aged 65 years and older with an ASA risk score of I-III, scheduled for elective surgery, were included in the study. Frailty status of the patients was determined using the "Barthel Index of Activities of Daily Living." All patients underwent routine preanesthetic evaluation, general anesthesia, and a recovery protocol using the Modified Aldrete Score expanded by Prof. Dr. Azize Beştaş. Recovery scores and times were recorded at entry into the recovery unit, as well as at the 5th, 10th, 15th, 20th, 25th, and 30th minutes, and at discharge. The relationship between frailty scores and recovery time was assessed. Of the 153 patients included in the study, 100 (65.4%) were non-frail, 43 (28.1%) were pre-frail, and 10 (6.5%) were frail. Among females, 63.6% were non-frail, 32.5% were pre-frail, and 3.9% were frail. Among males, 67.1% were non-frail, 23.7% were pre-frail, and 9.2% were frail, with no statistically significant difference observed between genders in terms of frailty. Among non-smokers, 3.9% were frail, while among smokers, 37.7% were pre-frail and 9.1% were frail, indicating a significant difference in frailty based on smoking status. Of patients with coronary artery disease (CAD), 10.3% were frail, and among patients with malignancy, 14.3% were frail, both showing statistically significant associations. The baseline SPO2 values of frail patients were significantly lower compared to non-frail patients. Frail patients also demonstrated lower Modified Aldrete Scores at entry and at the 5th, 10th, and 15th minutes of recovery. There was a significant difference in recovery times based on frailty status, with non-frail patients having the shortest recovery times and frail patients the longest. Frail patients also exhibited prolonged extubation times, response times to verbal commands (opening eyes, sticking out the tongue), and head lift durations compared to non-frail patients. In conclusion, in our study examining the recovery processes of geriatric patients from general anesthesia, similar hemodynamic changes, pain, and nausea-vomiting scores were observed in all patients during the recovery period. However, a significant relationship was identified between recovery time and the degree of frailty. Therefore, it is concluded that determining the frailty status of all geriatric patients scheduled for surgical intervention, considering the potential prolongation of anesthesia recovery time, and ensuring close monitoring are essential. Keywords: Geriatrics, frailty, postoperative recovery