Oral Presentation Australian and New Zealand Society for Geriatric Medicine Annual Scientific Meeting 2026

Association of frailty with functional recovery after elective noncardiac surgery in older adults   (#69)

Andrea Taylor 1 2 , Carl Lisec 1 , Lee Jones 3 , Alison Craswell 4 , Nicole Marsh 5 , Alison Mudge 6
  1. Surgical and Perioperative Services, Royal Brisbane and Women's Hospital, Herston, Queensland , Australia
  2. Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia
  3. Statistics Unit, QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia
  4. School of Health, University of the Sunshine Coast, Sippy Downs, Queensland, Australia
  5. Nursing and Midwifery Research Centre, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
  6. Internal Medicine and Aged Care, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia

 

Aims To examine the association between frailty and patient-reported functional recovery following elective noncardiac surgery in older adults.

Methods A prospective longitudinal cohort study was conducted among adults aged ≥70 years undergoing elective noncardiac surgery at a tertiary hospital. Frailty was assessed preoperatively using the Clinical Frailty Scale (CFS), with frailty defined as CFS ≥4. Primary outcomes were decline in basic activities of daily living (ADL) and instrumental activities of daily living (IADL). Secondary outcomes included disability and community mobility assessed using validated patient-reported measures. Outcomes were assessed at one and six months post-discharge. Associations were examined using multivariable logistic regression adjusted for age, sex, surgical risk, ASA score and baseline function.

Results Among 270 participants (mean age 77.8 years; 67% male), 45% were classified as frail. ADL decline was uncommon and did not differ by frailty status at one or six months. However, frailty was independently associated with greater IADL decline at six months (adjusted OR 2.92, 95% CI 1.52–5.65). Frail participants also experienced greater disability at one and six months (adjusted OR 2.17, 95% CI 1.13–4.23; and OR 2.65, 95% CI 1.39–5.12) and reduced community mobility at one month (adjusted OR 2.41, 95% CI 1.28–4.68).

Conclusions Frailty was associated with persistent decline in higher-order functional domains following elective surgery, despite preserved basic self-care. Frailty screening may help identify older adults at risk of incomplete recovery and support care planning aligned with patient priorities.