EMSFI (Emergency Surgery Frailty Index): A New Validated Score in the Elderly Undergoing Emergency Surgery

Introduction Several studies suggest that frailty predisposes elderly to a worse outcome after surgery. Since emergency surgery is associated with higher mortality rates, it’s important to establish an accurate stratification of surgical risk in such patients. Section snippets Methods The aim of our study is to identify a new preoperative Frailty Index to assess risk of elderly population underwent acute care surgery.784 patients older than 65 years who required emergency surgical procedures were recruited from 43 italian centers partecipating at the FRAILESEL study, between December 2016 and May 2017. With the aim of developing an index of fragility in emergency surgery called "EmSFI”, a study of the most common comorbidities and clinical factors was carried out, evaluating Results EmSFI was calculated on our population. The mean value was 3.81 ± 2.29 (range 1-12). Analyzing the frequencies of morbidity and mortality compared to the various EMSFI classes, these have increased as the value of the index increases. Both the score of P-POSSUM and EMSFI proved to be moderately accurate predictors of mortality (AUC 0.750 vs AUC 0.731). While as regards morbidity, only P-POSSUM proved to be a moderately accurate test (AUC 0.727). Conclusion In conclusion EMSFI represents a feasible method to calculate frailty index in emergency surgery. Obviously further studies are needed to confirm our results in order to use this score in clinical practice.