Determination of the relationship between Frail frailty index, ASA scoring, neutrophil-lymphocyte ratio, erythrocyte distribution width and mortality and morbidity in geriatric patients

Determination of the Relationship between Frail Frailty Index, ASA Scoring, Neutrophil-Lymphocyte Ratio and Erythrocyte Distribution Width and Mortality and Morbidity in Geriatric Patients Purpose and Hypothesis: The increase in the geriatric population in the world also leads to an increase in the number of geriatric surgeries. Clinicians should be more careful in the follow-up of the elderly patient group due to some physiological changes that occur with age. Our aim in this study is to determine the power of Frail index, ASA scoring and hemogram findings to be applied to the patient in the preoperative period to predict postoperative mortality and morbidity. Method: This prospective study was carried out between 01.05.2020 and 31.12.2021 with geriatric patients who were scheduled for elective surgery in Bozok University Research and Practice Hospital. Frail frailty index was applied to the patients in the preoperative period, and the ASA scores were determined. Preoperative and postoperative hemogram data (which were taken in the first 24 hours) of the patients were recorded. Results: In the study, which included a total of 167 patients, 56 (33.5%) of the patients were female and 111 (66.5%) were male. The mean age of the patients was 74.6±8.01 (age range 65-102). When we classified patients according to the frailty index, 66 patients (39.5%) were evaluated as normal, 63 patients (37.7%) as prefrail, and 38 patients (22.8%) as frail. When we classified patients according to ASA scores, we did not have any patients in the ASA I group, while 50 patients (29.9%) were ASA II ; 84 patients (50.3%) were ASA III; 33 patients (19.8%) were found in ASA IV group. When all groups were evaluated in terms of postoperative three-month mortality and morbidity, Frail index, ASA, preoperative NLR, postoperative NLR, preoperative RDW-SD and postoperative RDW-SD were found to be the most effective parameters in predicting mortality and morbidity (p<0.0001, p<0.0001, p<0.0001, p=0.002, p<0.0001, respectively). Conclusion: Our study shows that preoperative combined evaluation of ASA scoring, Frail frailty index, NLR, and RDW of the geriatric patients will have a higher prediction of mortality and morbidity in the postoperative three-month period follow up. Keywords: preoperative; ASA; frail; RDW; NLR; geriatric patient