Focus on ‘futile’ surgery

A PERSON’S frailty could be measured to decide if they are able to survive and benefit from an operation amid calls for ‘futile’ surgeries to be scrutinised for elderly Australians.

Melbourne hospitals are developing a Frailty Index to measure how well a person will recover after surgery that may provide a better indication if they should undergo an operation than just considering their age.

It comes as the Australian and New Zealand College of Anaesthetists calls for doctors and families to have frank and open discussions about the benefits of surgery and the risk of inappropriate operations.

Over-65s make up 15 per cent of Australia’s population but account for one in three emergency surgeries and more than 40 per cent of elective operations. With seniors set to double over the next 20 years Royal Melbourne Hospital anaesthetist and intensive care specialist Dr Jai Darvall said more accurate methods of assessing suitability for surgery were needed.

By measuring frailty indica-

“We are aiming to improve … quality of life”

tors in a group of 250 patients before and after surgery Dr Darvall is building an index of factors which measure to how a person will recover.

The index shows a threshold beyond which patients are considered “vulnerable” or “frail”, flagging the need for greater surgical support or alternatives, although Dr Darvall said there is no intent to outright deny operations.

“You could have a really fit 80-year-old who is running marathons who poses less of a surgical risk than a 60-yearold frail person,” he said.

ANZCA president Prof David Scott said the aim of anaesthesia and surgery “is to improve somebody’s quality of life – it is not just about quantity, it is about quality.”