{"id":12300,"date":"2017-10-02T14:41:39","date_gmt":"2017-10-02T20:41:39","guid":{"rendered":"https:\/\/www.uchealth.org\/today\/?p=12300"},"modified":"2023-09-01T11:59:41","modified_gmt":"2023-09-01T17:59:41","slug":"strong-enough-for-surgery","status":"publish","type":"post","link":"https:\/\/www.uchealth.org\/today\/strong-enough-for-surgery\/","title":{"rendered":"Strong enough for surgery?"},"content":{"rendered":"
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There is no foolproof way to predict the outcome of even the most routine surgery. There is always risk, regardless of the skill of the surgical team or the quality of care hospital staff provide after the procedure.<\/p>\n

\"A
A few of the simple tools needed for a frailty assessment: grip measurement instrument, a tape measure for walking speed, a smartphone (which plays the role of a stopwatch in recording walking time), a consent form and a pen for filling it out. The data gleaned from these low-tech items could yield powerful data in predicting surgical outcomes for patients with brain tumors.<\/figcaption><\/figure>\n

Health care teams recognize this and routinely assess factors that could increase patients\u2019 surgical risk, including their age, comorbidities like heart problems, and lifestyle choices like smoking. There is also the question of a patient\u2019s overall condition. Does the individual have deep enough physical reserves to withstand and recover from the shock of surgery?<\/p>\n

It\u2019s a question that D. Ryan Ormond, MD<\/a>, has considered \u2013 and with good reason. As a neurosurgeon and director of the Brain Tumor Program<\/a> at UCHealth\u2019s University of Colorado Hospital, he often opens patients\u2019 skulls to remove tumors, both benign and malignant. He\u2019d like to make a crystal-clear assessment of his patients\u2019 risk before such sensitive surgeries, but that\u2019s not always easy.<\/p>\n

\u201cSometimes I get the impression that one patient might do worse than another,\u201d Ormond said. The warning signs can be subtle, he added. \u201cWe look at cardiac risk, for example,\u201d he said. \u201cSometimes there is none, but I still have the impression that the patient won\u2019t do well.\u201d<\/p>\n

To firm up those impressions, Ormond is leading a study at UCH<\/a> that measures the frailty of patients with brain tumors \u2013 weakened grip, difficulty walking or physical exhaustion, for example \u2013 before neurosurgery. The goal: assess how well frailty predicts undesirable outcomes of the surgeries, including complications, longer hospital stays, and discharges to places other than home.<\/p>\n

Signs of weakness<\/h3>\n

It\u2019s the first time that a study has looked at frailty as a factor in predicting surgical risk for brain tumor patients. But the idea that patients\u2019 physical capacity should be considered independently in assessing risks to health was established in a 2001 study<\/a> of 5,300 elderly patients. The work isolated five criteria for frailty (see box) <\/em>and developed a scale for measuring it.<\/p>\n

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Assessing frailty<\/strong><\/p>\n

The criteria used to define frailty with the calculator developed at Johns Hopkins University include:<\/p>\n