RESUMEN
Background: In the perioperative context, a frailty evaluation scale must consider certain characteristics such as validation, execution speed, simplicity, the capacity to measure multiple dimensions and not being dependent on a cognitive or physical test that could not be performed prior to surgery. The test should select patients that could benefit from interventions aimed to improve their postoperative outcomes. Aim: To validate two frailty evaluation scales for the perioperative period. Material and Methods: The Risk Analysis Index with local modifications (RAI-M) were applied to 201 patients aged 73 ± 7 years (49% women) and the Edmonton frailty scale were applied in 151 patients aged 73 ± 7 years (49% women) in the preoperative period. Their results were compared with the Rockwood frailty index. Results: The Edmonton frail scale showed adequate psychometric properties and assessed multiple dimensions through 8 of the 11 original questions, achieving a discrimination power over 80% compared to the Rockwood Index. The RAI- M, demonstrated solid psychometric properties with a tool that examines 4 dimensions of frailty through 15 questions and reviewing the presence of 11 medical comorbidities. This scale had a discrimination power greater than 85% and it was significantly associated with prolongation of the planned hospital stay and mortality. Conclusions: RAI-M is a short and easily administered scale, useful to detect frailty in the preoperative period.
Asunto(s)
Humanos , Masculino , Femenino , Anciano , Anciano de 80 o más Años , Fragilidad , Complicaciones Posoperatorias , Evaluación Geriátrica , Anciano Frágil , Medición de Riesgo , Periodo PreoperatorioRESUMEN
Se analizaron las historias clinicas de 50 pacientes consecutivos que recibieron vagotomia supraselectiva (VSS) como tratamiento de ulcera duodenal, en el Hospital San Igancio de Bogota entre 1976 y 1984. El 74% corresponde al sexo masculino con promedio de edad de 34.9 anos y 6.2 anos de presentar sintomas ulcerosos. La indicacion mas frecuente fue la intratabilidad en 24 casos: la evolucion postoperatoria fue satisfactoria con una estancia hospitalaria de 6.4 dias sin mortalidad operatoria ni postoperatoria. La sensacion de distension abdominal fue la molestia prosoperatoria mas frecuente, presente en 8 pacientes. El seguimiento se realizo en un lapso de 5 a 14 anos. La clasificacion de Visck muestra 86.6% en los grupos I y II y solo se presentaron 2 (6.6%) recidivas ulcerosas comprobadas. La VSS se considera como una operacion segura y con resultados satisfactorios en el tratamiento de la ulcera duodenal intratable