New Orleans— An innovative study by Dr. Hernan Bazan at Ochsner Health and colleagues reveals how frailty assessments can accurately predict outcomes in urgent carotid artery interventions for stroke patients. The study, currently in press in The Journal of Vascular Surgery (1), analyzed 307 patients over eight years and found that higher frailty scores were directly associated with increased rates of stroke, death, and myocardial infarction (MI) within 30 days of the carotid procedure.
Utilizing the Hospital Frailty Risk Index (HFRI), which was initially published in The Lancet (2018) by another group, Dr. Bazan and his team developed stroke-specific risk categories that provide enhanced predictability of adverse outcomes, underscoring the importance of frailty assessment in preoperative planning. This tool uses ICD-10 codes, each weighted by their impact on frailty, to efficiently identify frailty in elderly patients, streamlining assessments in acute care settings. This approach offers a systematic, low-cost tool for assessing frailty risk across large populations, removing manual assessments' subjectivity and time constraints. Additionally, the score predicts adverse outcomes, making it a valuable resource for hospital systems worldwide to allocate resources better and improve care outcomes.
“This study not only offers critical insights into the influence of frailty on surgical outcomes but also demonstrates the commercial potential of predictive analytics in improving patient safety, reducing hospital costs, and enhancing decision-making for physicians and insurers,” said Dr. Bazan. “By incorporating frailty assessment into clinical practice, we can better anticipate risks and make tailored treatment decisions to improve patient outcomes. As we move toward a more personalized approach in medicine, these findings will undoubtedly shape how we evaluate and manage frail patients undergoing high-risk procedures.”
Dr. Dan Fort, study co-author and Biomedical Research Informatics Program Manager at Ochsner, continued, “The potential scalability of our approach, seamlessly integrated into electronic medical records (EMRs) via Substitutable Medical Applications, Reusable Technologies (SMART) on Fast Healthcare Interoperability Resources (FHIR), positions it as a versatile solution for global health systems.”
The study demonstrates the direct relationship between frailty and adverse outcomes, such as stroke, death, and myocardial infarction, within 30 days of intervention, which could guide future surgical guidelines, help surgeons better assess risk, and result in improved patient outcomes.
Dr. Frank Opelka, who is the Immediate Past Medical Director for Quality and Health Policy at the American College of Surgeons and was not associated with this study, commented: “This study highlights the clinical and financial benefits of incorporating predictive analytics, like frailty assessments, into value-based care models. Dr. Bazan’s work represents a major advancement in shared decision-making and patient care, offering significant value to patients, families, physicians, and payers. The scalability within EMRs makes it an excellent program with broad potential.”
Dr. Bazan's research is supported by The John Ochsner Heart and Vascular Institute Distinguished Endowed Professorship, highlighting Ochsner Health's dedication to advancing precision medicine and patient-specific treatments. This endowment, honoring Dr. John Ochsner's legacy, provides Dr. Bazan with resources to focus on innovations in clinical care, clinical and translational research, and physician training.
Reference:
- Hilaire C, Burton J, Lunkkadi K, Sternbergh WC, Money S, Fort D, Bazan HA. Frailty Scores Impact the Outcomes of Urgent Carotid Interventions in Acute Stroke Patients. Journal of Vascular Surgery in press 2024. DOI: DOI: 10.1016/j.jvs.2024.07.096
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About Ochsner Health
Ochsner Health is the leading not-for-profit healthcare provider in the Gulf South, delivering expert care at its 46 hospitals and more than 370 health and urgent care centers. For 13 consecutive years, U.S. News & World Report has recognized Ochsner as the No. 1 hospital in Louisiana. Additionally, Ochsner Children’s has been recognized as the No. 1 hospital for kids in Louisiana for four consecutive years. Ochsner inspires healthier lives and stronger communities through a combination of standard-setting expertise, quality and connection not found anywhere else in the region. In 2023, Ochsner Health cared for more than 1.5 million people from every state in the nation and 65 countries. Ochsner’s workforce includes more than 38,000 dedicated team members and over 4,700 employed and affiliated physicians. To learn more about how Ochsner empowers people to get well and stay well, visit https://www.ochsner.org/.
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