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Background and Aims Frailty is a syndrome characterized by multi-system dysfunction and poor stress response, leading to falls, disability, increased morbidity, and mortality. This study aims to determine the prevalence of frailty in elderly patients undergoing spinal anesthesia for lower limb fractures and identify key frailty factors to optimize them preoperatively.
Methods Over a 4-month period, 64 eligible patients undergoing surgery for fractures due to falls were included. Following informed consent, patients completed a pre-designed questionnaire including socio-demographic information, medical history, and the Tilburg Frailty Indicator (TFI), a validated tool for use in Greece that assesses physical, psychological, and social frailty factors. TFI scores ≥5 indicate frailty (statistical analysis: SPSS 26, p≤0.5).
Results The mean age was 82.06 ± 9.26 years. Of the participants, 62.5% were female, 76.6% had <9 years of education, 90.6% were retired, 57.8% were married, 42.2% were widowed. 71.9% reported prior falls, while 70.3% feared future falls. 40.6% used ≥5 medications/day, and 21.9% had ≥5 coexisting diseases. According to the TFI, 57.8% of patients were frail. Frailty was significantly associated with older age, lower education level, widowhood, fear of falling, polypharmacy (≥5 medications/day), and multimorbidity.
Conclusions A considerable proportion of elderly patients with lower limb fractures were identified as frail. It is crucial to implement preoperative interventions on a large scale (e.g., empowerment programs, psychological support, exercise, a healthy diet, and minimizing polypharmacy) to reduce frailty and optimize patient conditions before surgery, in order to promote healthy aging and ensure that patients are in the best possible condition prior to surgery
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