1. John Budrow and Keith Spencer Dr Stefan and Dr Lagu

2. Outline Background Objective/ Aims Daily routine Preliminary Results Future Directions

3. Background Adults ≥ 65 years comprise 13% of US residents and are one of the fastest growing segments of the population Current preop risk assessment is system based Frailty: decrease in physiological reserve

4. Importance of Frailty Risk

5. Objective/ Aims 1. To explore the association between frailty and complications developed during and/or within 90 days

6. Emergent surgeries Patients who do not speak English InclusionExclusion Older than 65 yearsEmergent surgeries Urgent noncardiac surgery/ TraumaPatients that do not speak English Elective SurgeryPatients that have dementia/ delirium without a proxy Medical patients: CHF, PNA, COPDPost operative patients Patients that have been in the hospital < 2 days

7. Study Outcomes Primary outcome: postoperative complications during hospitalization or readmission at 90 days Delirium, falls, pressure ulcers Other outcomes: Length of stay Mortality Readmissions Time spent at nursing home/ rehab facility Patient and family satisfaction (survey + complains)

10. Enrollment Process and data collection Screening Consent/ assessment CAM/ Post-op Survey Data entry Phone call follow up

11. Screening CIS 30 to 60 minutes

12. Consent/ Assesment 15 to 90 minutes Extensive Training Useful keywords Changes to consent form

13. Delirium Evaluation with CAM Acute onset/ fluctuating levels of consciousness Inattention Disorganised speech Altered level of consciousness Varying reasons for onset

14. Post-op survey 5 to 15 minutes Satisfaction survey

15. Data Entry REDCap 20 to 40 Minutes Schedule Follow ups

16. Phone Follow Ups 5 to 20 minutes Prescreen CIS for changes

17. Results 147 patients currently enrolled 84 (~59%) female Mean age 76.66 Urgent surgery- 53 Elective surgery-32 Medical- 64

18. Frailty of Enrolled Patients

19. Results

20. Future Direction Assess the quality of care from a multidisciplinary coordinated care team targeting prefrail/frail patients Same inclusion and exclusion criteria, same frailty assessment and collect same variables as for phase 1/aim 1

22. Thank you Dr. Stefan Dr. Lagu Summer Scholars Program Other project coordinators

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