The prevalence of frailty and its associated factors among preoperative elective elderly surgical patients in selected referral hospitals, Addis Ababa, Ethiopia, 2023/2024: A multi-center cross sectional study.
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Date
2024-06
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Addis Ababa University
Abstract
Background: Frailty is a phenotype that identifies people with reduced physiological reserve in
multiple organ systems. The prevalence of frailty in surgical patients ranges from 4.1% to 50.3%.
Frailty can leads to infection, increase healthcare intervention and hospitalization in elderly
surgical patients. Thus preoperative identification of factors causing frailty is critical for
determining patient suitability for surgery.
Objectives: To assess the prevalence of frailty and its associated factor in preoperative elderly
surgical patient at Addis Ababa referral hospitals, Ethiopia from February –April 2024.
Method: A multi-center cross sectional study was conducted on 422 elderly surgical patients in
selected referral hospitals in Addis Ababa, Ethiopia from February-April 2024. The data was
collected after obtaining consent, and the study participants were chosen using a method of
systematic random sampling. Data was checked, coded, entered, and analyzed by using
Statistical Package for Social Science version 26. Multinomial logistic regression analyses were
performed to identify a statistically significant association between the independent and
dependent variables. Finally, variables are significant when their p-value is less than 0.05.
Result: The prevalence of frailty and pre-frailty in elective elderly surgical patients was 23.7%
(95% CI: 19.7% to 28%) and 35.1% (95% CI: 30.5% to 39.8%), respectively. Sex (AOR: 2.326,
95%CI: 1.112–4.863), age (AOR:2.308, 95%CI:1.120–4.574), depression (AOR:2.747,
95%CI:1.295–5.826), presence of more than two coexisting disease (AOR:9.049, 95%CI:1.633–
50.147) and use of more than two medications (AOR:7.320, 95%CI:1.884–28.450) were found
to be significantly associated with frail and sex(AOR:1.733, 95%CI 1.034-2.906)and residence
(AOR:1.996, 95%CI:1.162–3.429) were found to be significantly associated with pre-frail
Conclusion and recommendation: More than 1/5th of surgical patients were frail, and more
than 1/3rd of surgical patients were pre-frail. Patient age, sex, depression, the presence of co-
existing disease, and medication usage were identified factors of frailty. Pre-frailty, on the other
hand, was linked to patient sex and residence status. Early assessment and pre-rehabilitation of
elective elderly surgical patients with depression, coexisting disease and those who uses more
than two medications, before surgery is recommended and may lead to a good surgical outcome.
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Keywords
Frailty, elderly, elective, surgery