Frailty in surgical patients

Area of Science:

• Geriatric Medicine
• Surgical Oncology
• Peri-operative Care

Background:

• Frailty is a growing concern in surgery, linked to adverse events and poor outcomes.
• An aging global population leads to more older patients, and thus more frail patients, undergoing surgery.
• Lack of consensus exists on defining, measuring, and diagnosing frailty.

Purpose of the Study:

• To outline current definitions, causes, assessment tools, and clinical implications of frailty in surgical practice.
• To highlight the impact of frailty on surgical patient outcomes.
• To review the challenges in diagnosing and managing frailty in a surgical context.

Main Methods:

• Literature search conducted using keywords in Cochran, MEDLINE, and EMbase databases.
• Review of existing studies on frailty in surgical patients.
• Synthesis of information on frailty definitions, etiology, assessment, and outcomes.

Main Results:

• Frailty is characterized by reduced physiological reserve, increasing vulnerability to stressors.
• A strong association exists between frailty and adverse peri-operative outcomes.
• Multiple assessment tools are available, but an ideal clinical tool is yet to be identified; few interventions improve outcomes.

Conclusions:

• Frailty identifies surgical patients at high risk for adverse outcomes.
• Optimal assessment strategies and targeted interventions for frail surgical patients require further investigation.
• Ongoing research should focus on improving the management of frailty in surgery.