Frailty tracks surgical risk while arthritis adds discharge needs

In a cross-sectional study of 8,800,359 elective non-cardiac surgical hospitalizations among adults in the National Inpatient Sample from 2018 to 2020, researchers evaluated how frailty and rheumatoid arthritis relate to postoperative outcomes. Rheumatoid arthritis was documented in 2.14% of admissions, and 62.25% had a Hospital Frailty Risk Score greater than zero. Overall, 28.9% required discharge health resources, 0.93% experienced composite adverse clinical events, and 0.17% died.

A 10-point increase in the frailty score was associated with a 3.8-fold increase in discharge resource needs, an 8.5-fold increase in adverse clinical events, and a 22.8-fold increase in mortality. After adjusting for confounders and frailty, rheumatoid arthritis was not independently associated with adverse events or inpatient mortality. However, rheumatoid arthritis was associated with a 1.28-fold higher adjusted odds of needing discharge health resources, an association observed following orthopedic but not non-orthopedic intermediate-risk procedures.