Frailty Assessment Predicts Acute Outcomes in Patients Undergoing Screening Colonoscopy

Sasha Taleban, Nima Toosizadeh, Shilpa Junna, Todd Golden, Sehem Ghazala, Rita Wadeea, Coco Tirambulo, Martha J Mohler

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background: Colonoscopy is associated with multiple adverse outcomes. With an aging population undergoing colorectal cancer screening, few modalities exist to assess the patient risk prior to colonoscopy. Frailty, the age-related decline in reserve and function across multiple organ systems, predicts poor surgical outcomes, but its role in endoscopy is unclear. Aims: This prospective cohort study assesses the efficacy of frailty in predicting acute colonoscopy outcomes. Methods: Participants aged ≥ 50 years undergoing screening colonoscopy at a tertiary care center were recruited over 2 months ending in July 2017. Frailty was assessed using a validated 20-s upper-extremity frailty test, which measures the capacity of muscle performance. Demographic data, American Society of Anesthesiologists (ASA) status, and Charlson comorbidity index (CCI) were evaluated. Procedure-related adverse events and cardiopulmonary changes during and in the immediate post-procedure period were recorded. Adverse events were stratified into minor and major events. Chi-square and ANCOVA models were used in the analysis. Results: Ninety-nine adults (mean age 62.8 years) were enrolled, among which 49 were non-frail and 50 were pre-frail/frail; 50 were female. Overall, 55 participants experienced a total of 87 adverse events. Frailty and ASA status were significantly associated with colonoscopy adverse events (p = 0.01 and p = 0.02, respectively). Age and CCI did not predict colonoscopy outcomes. Conclusions: Compared to age and CCI, frailty status better predicts colonoscopy outcomes in older adults. Among adults undergoing colonoscopy, routine frailty screening should be considered for risk stratification. Additional prospective studies evaluating frailty measurements in endoscopy will further clarify its role in forecasting adverse events.

Original languageEnglish (US)
Pages (from-to)1-9
Number of pages9
JournalDigestive Diseases and Sciences
DOIs
StateAccepted/In press - May 24 2018

Fingerprint

Colonoscopy
Comorbidity
Endoscopy
Prospective Studies
Early Detection of Cancer
Tertiary Care Centers
Upper Extremity
Colorectal Neoplasms
Cohort Studies
Demography
Muscles
Population

Keywords

  • Age
  • ASA
  • Colonoscopy
  • Comorbidity
  • Frailty
  • Older
  • Outcomes
  • Screening

ASJC Scopus subject areas

  • Physiology
  • Gastroenterology

Cite this

Frailty Assessment Predicts Acute Outcomes in Patients Undergoing Screening Colonoscopy. / Taleban, Sasha; Toosizadeh, Nima; Junna, Shilpa; Golden, Todd; Ghazala, Sehem; Wadeea, Rita; Tirambulo, Coco; Mohler, Martha J.

In: Digestive Diseases and Sciences, 24.05.2018, p. 1-9.

Research output: Contribution to journalArticle

Taleban, Sasha ; Toosizadeh, Nima ; Junna, Shilpa ; Golden, Todd ; Ghazala, Sehem ; Wadeea, Rita ; Tirambulo, Coco ; Mohler, Martha J. / Frailty Assessment Predicts Acute Outcomes in Patients Undergoing Screening Colonoscopy. In: Digestive Diseases and Sciences. 2018 ; pp. 1-9.
@article{d7d3e22cf8664205af37befb640a5f0c,
title = "Frailty Assessment Predicts Acute Outcomes in Patients Undergoing Screening Colonoscopy",
abstract = "Background: Colonoscopy is associated with multiple adverse outcomes. With an aging population undergoing colorectal cancer screening, few modalities exist to assess the patient risk prior to colonoscopy. Frailty, the age-related decline in reserve and function across multiple organ systems, predicts poor surgical outcomes, but its role in endoscopy is unclear. Aims: This prospective cohort study assesses the efficacy of frailty in predicting acute colonoscopy outcomes. Methods: Participants aged ≥ 50 years undergoing screening colonoscopy at a tertiary care center were recruited over 2 months ending in July 2017. Frailty was assessed using a validated 20-s upper-extremity frailty test, which measures the capacity of muscle performance. Demographic data, American Society of Anesthesiologists (ASA) status, and Charlson comorbidity index (CCI) were evaluated. Procedure-related adverse events and cardiopulmonary changes during and in the immediate post-procedure period were recorded. Adverse events were stratified into minor and major events. Chi-square and ANCOVA models were used in the analysis. Results: Ninety-nine adults (mean age 62.8 years) were enrolled, among which 49 were non-frail and 50 were pre-frail/frail; 50 were female. Overall, 55 participants experienced a total of 87 adverse events. Frailty and ASA status were significantly associated with colonoscopy adverse events (p = 0.01 and p = 0.02, respectively). Age and CCI did not predict colonoscopy outcomes. Conclusions: Compared to age and CCI, frailty status better predicts colonoscopy outcomes in older adults. Among adults undergoing colonoscopy, routine frailty screening should be considered for risk stratification. Additional prospective studies evaluating frailty measurements in endoscopy will further clarify its role in forecasting adverse events.",
keywords = "Age, ASA, Colonoscopy, Comorbidity, Frailty, Older, Outcomes, Screening",
author = "Sasha Taleban and Nima Toosizadeh and Shilpa Junna and Todd Golden and Sehem Ghazala and Rita Wadeea and Coco Tirambulo and Mohler, {Martha J}",
year = "2018",
month = "5",
day = "24",
doi = "10.1007/s10620-018-5129-x",
language = "English (US)",
pages = "1--9",
journal = "Digestive Diseases and Sciences",
issn = "0163-2116",
publisher = "Plenum Publishers",

}

TY - JOUR

T1 - Frailty Assessment Predicts Acute Outcomes in Patients Undergoing Screening Colonoscopy

AU - Taleban, Sasha

AU - Toosizadeh, Nima

AU - Junna, Shilpa

AU - Golden, Todd

AU - Ghazala, Sehem

AU - Wadeea, Rita

AU - Tirambulo, Coco

AU - Mohler, Martha J

PY - 2018/5/24

Y1 - 2018/5/24

N2 - Background: Colonoscopy is associated with multiple adverse outcomes. With an aging population undergoing colorectal cancer screening, few modalities exist to assess the patient risk prior to colonoscopy. Frailty, the age-related decline in reserve and function across multiple organ systems, predicts poor surgical outcomes, but its role in endoscopy is unclear. Aims: This prospective cohort study assesses the efficacy of frailty in predicting acute colonoscopy outcomes. Methods: Participants aged ≥ 50 years undergoing screening colonoscopy at a tertiary care center were recruited over 2 months ending in July 2017. Frailty was assessed using a validated 20-s upper-extremity frailty test, which measures the capacity of muscle performance. Demographic data, American Society of Anesthesiologists (ASA) status, and Charlson comorbidity index (CCI) were evaluated. Procedure-related adverse events and cardiopulmonary changes during and in the immediate post-procedure period were recorded. Adverse events were stratified into minor and major events. Chi-square and ANCOVA models were used in the analysis. Results: Ninety-nine adults (mean age 62.8 years) were enrolled, among which 49 were non-frail and 50 were pre-frail/frail; 50 were female. Overall, 55 participants experienced a total of 87 adverse events. Frailty and ASA status were significantly associated with colonoscopy adverse events (p = 0.01 and p = 0.02, respectively). Age and CCI did not predict colonoscopy outcomes. Conclusions: Compared to age and CCI, frailty status better predicts colonoscopy outcomes in older adults. Among adults undergoing colonoscopy, routine frailty screening should be considered for risk stratification. Additional prospective studies evaluating frailty measurements in endoscopy will further clarify its role in forecasting adverse events.

AB - Background: Colonoscopy is associated with multiple adverse outcomes. With an aging population undergoing colorectal cancer screening, few modalities exist to assess the patient risk prior to colonoscopy. Frailty, the age-related decline in reserve and function across multiple organ systems, predicts poor surgical outcomes, but its role in endoscopy is unclear. Aims: This prospective cohort study assesses the efficacy of frailty in predicting acute colonoscopy outcomes. Methods: Participants aged ≥ 50 years undergoing screening colonoscopy at a tertiary care center were recruited over 2 months ending in July 2017. Frailty was assessed using a validated 20-s upper-extremity frailty test, which measures the capacity of muscle performance. Demographic data, American Society of Anesthesiologists (ASA) status, and Charlson comorbidity index (CCI) were evaluated. Procedure-related adverse events and cardiopulmonary changes during and in the immediate post-procedure period were recorded. Adverse events were stratified into minor and major events. Chi-square and ANCOVA models were used in the analysis. Results: Ninety-nine adults (mean age 62.8 years) were enrolled, among which 49 were non-frail and 50 were pre-frail/frail; 50 were female. Overall, 55 participants experienced a total of 87 adverse events. Frailty and ASA status were significantly associated with colonoscopy adverse events (p = 0.01 and p = 0.02, respectively). Age and CCI did not predict colonoscopy outcomes. Conclusions: Compared to age and CCI, frailty status better predicts colonoscopy outcomes in older adults. Among adults undergoing colonoscopy, routine frailty screening should be considered for risk stratification. Additional prospective studies evaluating frailty measurements in endoscopy will further clarify its role in forecasting adverse events.

KW - Age

KW - ASA

KW - Colonoscopy

KW - Comorbidity

KW - Frailty

KW - Older

KW - Outcomes

KW - Screening

UR - http://www.scopus.com/inward/record.url?scp=85047253259&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85047253259&partnerID=8YFLogxK

U2 - 10.1007/s10620-018-5129-x

DO - 10.1007/s10620-018-5129-x

M3 - Article

SP - 1

EP - 9

JO - Digestive Diseases and Sciences

JF - Digestive Diseases and Sciences

SN - 0163-2116

ER -