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Frailty Index Helps Cut Readmissions, ICU Stays

By Philip Betbeze  
   April 19, 2018

A UPMC program that helps patients "prehabilitate" in preparation for elective surgery is helping reduce postoperative mortality, complications, readmissions, and longer ICU stays. 

A new tool deployed at the VA and the academic medical centers of the University of Pittsburgh Medical Center is helping to evaluate patients prior to surgery and has the potential to dramatically improve outcomes.

The algorithmic tool encourages physicians to speak with surgery patients who the tool flags as being at risk for complications, to ensure the patients will survive and thrive following an elective surgery, says Daniel Hall, MD, an associate professor of surgery at the University of Pittsburgh and a staff surgeon at the VA Pittsburgh Healthcare System.

Hall helped develop the tool after it was first proposed by Jason Johanning, MD. Johanning, chief of surgery at the Omaha VA Medical Center, recognized that mortality post-surgery was higher than it should have been based on variability, suggesting that some patients were dying due to high-risk for postoperative complications because of their "frailty" prior to surgery.

"I got involved in late 2014 and 2015 after [Johanning] had been doing this for two or three years, but he didn’t have resources to validate the tool in any meaningful way," says Hall. "The two of us teamed up and developed a risk analysis in a cohort of between 6,000 and 7,000 patients."

Hall brought the data to clinical leaders at UPMC and says it "caught their imagination."

Philip Betbeze is the senior leadership editor at HealthLeaders.

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