IMPLEMENTATION OF A RISK ANALYSIS INDEX-BASED PREOPERATIVE FRAILTY SCREENING AND MANAGEMENT PROGRAM
2024

Preoperative Frailty Screening Using Risk Analysis Index

publication Evidence: moderate

Author Information

Author(s): Khalighi Mehraneh, Thomas Amy, Brown Karl, Ritchey Katherine

Primary Institution: VA Puget Sound Healthcare System

Hypothesis

The agreement between provider-completed and patient-completed RAI-C scores is unknown.

Conclusion

Preoperative frailty screening is feasible with the RAI-C tool, but consistency varies between providers and patients.

Supporting Evidence

  • RAI screening occurred in 48% of eligible patients.
  • Providers were less accurate in referring frail patients compared to robust or very frail patients.
  • Screening frequency improved with dedicated nursing champions reminding providers to screen.
  • The correlation between patient-completed and provider-completed RAI-C was moderate (r=0.634).
  • Patient-completed RAI-C re-classified 29% of patients to a higher frailty category.

Takeaway

Doctors and patients can use a special form to check if someone is frail before surgery, but they might not always agree on the results.

Methodology

Orthopedic providers completed the RAI-C on Veterans ≥65 years awaiting surgery and compared scores with those completed by patients.

Limitations

The study did not specify the sample size and the agreement was lowest in certain domains.

Participant Demographics

Veterans aged 65 and older awaiting elective total joint arthroplasty.

Statistical Information

P-Value

<0.001

Statistical Significance

p<0.001

Digital Object Identifier (DOI)

10.1093/geroni/igae098.1562

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