Frail adults should be consulted about their care preferences after emergency surgery, as they are at high risk for poor one-year outcomes, according to surgeon-researchers.

The investigators linked frailty to a higher risk for death, likelihood of long-term care admissions and poorer health in the year following abdominal surgery.

The research team used Medicare claims to measure frailty in about 470,000 patients ages 65 years or older. Participants had undergone high-risk emergency abdominal surgery. 

Overall, about 16% of study participants died within 30 days of their surgery. Within 180 days, 25% had died, and 30% died at one year. Adults with moderate-to-severe frailty had the highest relative death rates compared to peers who were not frail. Those with mild frailty and pre-frailty were also at additional risk, said Zara Cooper, M.D., from Brigham and Women’s Hospital, Boston, and colleagues.

Frail older patients also spent six to 14 fewer weeks at home after discharge when compared to non-frail cohorts. And repeat hospital encounters such as emergency room visits were four to six times more likely.

“Targeted interventions for older emergency general surgery patients with frailty during … hospitalization are urgently needed to improve long‐term outcomes,” the researchers concluded.

Full findings were published online Tuesday in the Journal of the American Geriatrics Society.