More than half of all surgeries in the United States are performed on patients age 65 or older and one-third of patients aged 65-85 will undergo a major surgical procedure within the last year of life. For many patients, surgery will confer substantial benefits while others will experience significant harm. To obtain optimal surgical outcomes in this population, patient selection for surgical procedures is of utmost importance.
The ability to screen patients at risk for postoperative morbidity, mortality, and increased healthcare utilization has improved significantly based on the identification of the frail surgical patient. Frailty, defined by a complex phenotype of functional decline typical of patients near the end of life, is a more powerful predictor of surgical outcomes than classic risk factors including age and comorbidities. Frailty thus indicates a marked increased risk of death, disability and institutionalization. Unfortunately, widespread adoption of frailty screening has not occurred due to the inability to screen large patient populations in clinical settings. Subjective assessment therefore remains the predominant method of determining surgical risk.
FUTUREASSURE LLC under the guidance of Dr. Jason Johanning has developed a rapid clinical assessment system for surgical patients that has been implemented into the preoperative workflow of multiple medical centers in both public and private sector settings nationwide. Although a significant advance, measurement of surgical frailty in both clinical and research settings still relies on significant staff time and effort.
FUTUREASSURE LLC has addressed these issues by developing a novel device to automate collection of clinical and research frailty metrics in preoperative surgical patients utilizing standard clinical workflow. FUTUREASSURE LLC’s risk assessment system utilizes a prospective validated frailty metric collection that is more rapid, reliable and robust than current methods of collection and can be obtained during any surgeon office visit. The system importantly is agnostic to collection tools and EMR’s, thus providing a platform for collecting both clinical and research data that is usable across multiple platforms. FUTUREASSURE LLC’s Patent Pending concept is modular at every level with focus on meeting the need of the end user as clinician or researcher. The system is designed to accommodate a wide array of clinical and research metrics to use in practice with varying input options at all points of assessment. Exported data too will be modular with options to house data on a local hard drive, local EMR (Electronic Medical Record) and cloud-based services including transmission to national entities such as surgical registries and Centers for Medicare Services.
Once adopted in a widespread fashion, no longer will patients be relegated to a subjective and error prone eyeball test to determine whether they will tolerate a surgical procedure. Rather, patients and the surgeon will benefit from objective data that rapidly, accurately and reliably predicts surgical outcomes with a c-statistics comparable to other widely used clinical assessment tools. Additionally, the FUTUREASSURE LLC risk assessment system would provide a richer dataset using automated metrics allowing researchers to assess and quantify multiple individual frailty metrics that have previously not been compared or combined.
Surgical palliative care consultations over time in relationship to systemwide frailty screening.
Development and Initial Validation of the Risk Analysis Index for Measuring Frailty in Surgical Populations.
Association of a Frailty Screening Initiative With Postoperative Survival at 30, 180, and 365 Days.
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