Frail patients are more likely to have serious complications after elective outpatient surgery than people who are healthier and stronger, a recent study suggests.

Much of the previous research linking physical frailty to worse surgical outcomes has been based on what happens when people have major elective or emergency operations in a hospital, researchers note in JAMA Surgery, online October 11.

For the current study, researchers examined data on almost 141,000 adults who had some common elective procedures that don’t require hospital admission, such as hernia repairs, breast surgery and thyroid procedures.

Patient frailty should be considered as a risk factor for complications even in these common and seemingly `low risk’ outpatient procedures

While less than 1% of these patients experienced serious complications, the odds were twice as high for people with two or three traits associated with frailty, the study found. This level of frailty was also associated with 70% higher odds of any complications, including minor issues.

“The results of our study show that patient frailty should be considered as a risk factor for complications even in these common and seemingly `low risk’ outpatient procedures,” said lead study author Carolyn Seib of the University of California, San Francisco.

Frailty is a measure of decreased physiological function that can involve problems like weakness, exhaustion, slow walking speed or low activity levels. Even though frailty is often considered a hallmark of aging, patient age isn’t necessarily a good indicator of whether they may have traits that contribute to frailty.

Researchers looked for a history of several traits associated with frailty including: diabetes, impaired functional status, pneumonia or chronic lung disorder, congestive heart failure, heart attack, certain heart procedures, blood pressure medications, valve disease and stroke.

In addition, researchers accounted for age as well as other factors that can influence surgery outcomes such as sex, race and ethnicity, weight and other medical problems.

Overall, about 2,500 people experienced any type of complications within 30 days after surgery and roughly 970 individuals had serious complications, the study found.

Complications included pneumonia, unplanned insertion of a breathing tube or ventilator, cardiac arrest or heart attack, stroke or coma, kidney failure, bleeding and infections.

Based on the results, researchers conclude that accounting for frailty can provide a better picture of surgical risk than only relying on patient age.