Could you be denied surgery?

How frail you are could be used to assess whether you’ll qualify for surgery in the future, with hospitals calling for a ‘Frailty Index’ to help them minimise ‘futile’ surgeries.

The Frailty Index, currently being developed by Melbourne hospitals, will measure how well a person, specifically older people, will recover from surgery. It is being created to help them figure out whether a person will survive surgery and how long they’ll live after an operation.

Royal Melbourne Hospital anaesthetist and intensive care specialist Dr Jai Darvall will assess 250 patients before and after surgery, to discover the factors and indicators that should provide more accurate methods of assessing a person’s suitability for surgery.

The test comes after the Australian and New Zealand College of Anaesthetists (ANZCA) urged doctors and families to be more open about the true benefits of proposed surgery.

The benchmarks will indicate who may be beyond help and who could benefit, but is not intended to 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-year-old frail person,” said Dr Darvall.

“As you get older you accumulate deficits and that might be some comorbidities (such as) heart disease, lung disease, it might be problems with hearing or vision, problems with mobility, a person’s gait or arthritis, or not being able to do the stuff they used to.

“One by one, these things start to mount up and eventually they reach a threshold where you say a person is frail.

“It means that recovery is much harder and people are more likely to go on to poorer recovery, perhaps not getting back home or not getting back to functional independence.”

“In the end what we are aiming for with anaesthesia and surgery is to improve somebody’s quality of life — it is not just about quantity, it is about quality,” said ANZCA president Prof David Scott.

“And that means taking on board people’s own views and expectations and what they want to achieve.

“We are fixated on this idea that if there is a small chance of surviving then it is a success. But that may not be the case.

“It could be three months relatively pain free, highly-mobile quality of life compared to six months following a major operation with a long drawn out recovery, most likely some complications, and actually never getting back to that good quality life you expected.”

What do you think of this test? Would you welcome this type of assessment? Do you think that eliminating unnecessary procedures could, in turn, reduce the cost of health insurance?

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