The Impact of Patient Frailty on Readmission Morbidity and Mortality in Women Undergoing Ovarian Cancer Surgery [39H]. (May 2020)

• Record Type: Journal Article
• Authors: Sia, Tiffany; Wen, Timothy; Cham, Stephanie; Friedman, Alexander; Wright, Jason
• Is Part Of: Obstetrics and gynecology. Volume 135(2020)Supplement 1
• Publication Date: 2020-05
• Subjects: Obstetrics -- Periodicals; Gynecology -- Periodicals; 618
• DOI: 10.1097/01.AOG.0000664092.45596.06
• Languages: English
• ISSNs: 0029-7844

Abstract

Abstract : INTRODUCTION: Frailty, defined as loss of reserve and vulnerability to changes in health, affects many elderly patients. We investigated the effect of frailty on readmission and mortality rates in patients undergoing laparotomy for ovarian cancer. METHODS: Patients underwent laparotomy between 2010-2014 were identified using the Nationwide Readmissions Database. Frailty was identified using the Johns Hopkins Adjusted Clinical Groups Frailty Indicator, which requires 1 of 10 frailty defining diagnoses. Univariable and multivariable log linear regression analyses were conducted to analyze the association between frailty and 30-day and 90-day all cause readmission and mortality. Models were adjusted by patient, hospital, and clinical factors. RESULTS: We identified 78, 821 cases. Frailty affected 5.8% of patients. 30-day and 90-day readmission rates were 14.6% and 24.2%, respectively, with readmission mortality rates of 3.4% and 3.3% for 30- and 90-day readmissions. Frailty was independently associated with an 11% increased risk for both 30-day and 90-day readmission. Frailty was also associated with a 34% increased risk of mortality when readmitted at 90-days (RR 1.34, 95% CI 1.04-1.72, P =.02). Having two or more comorbid conditions, discharge to nursing facility, intermediate care facility or home health care, leaving against medical advice, receiving a postoperative blood transfusion, and having a medical or surgical complication increased the risk of 30- and 90-day readmissions and mortality at the time of readmission. CONCLUSION: Frailty is associated with an increased risk of readmission and a higher rate of mortality and should be considered when planning for ovarian cancer surgery.