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Related Experiment Video

Updated: Sep 18, 2025

Author Spotlight: Assessing Surgical Frailty with Point-of-Care Ultrasound of Quadriceps Muscles

Author Spotlight: Assessing Surgical Frailty with Point-of-Care Ultrasound of Quadriceps Muscles

Published on: July 26, 2024

Frailty in the perioperative setting: lessons from SNAP-3.

Simon J Howell¹, Jugdeep K Dhesi²

¹Leeds Institute of Medical Research, University of Leeds, St. James's University Hospital, Leeds, UK.

British Journal of Anaesthesia

|June 25, 2025

Summary

This summary is machine-generated.

The largest UK study found frailty significantly increases postoperative complications and mortality in older surgical patients. Routine frailty screening is crucial for improving surgical care and patient outcomes.

Keywords:

delirium frailty multimorbidity older surgical patients perioperative outcomes

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Published on: July 26, 2024

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Published on: May 11, 2020

Area of Science:

Geriatric Medicine
Perioperative Care
Surgical Outcomes

Background:

The Sprint National Anaesthesia Project (SNAP-3) is the largest UK prospective, multicentre study investigating frailty, multimorbidity, and delirium in surgical patients aged 60 years and older.
The study enrolled 7134 patients across 214 National Health Service (NHS) hospitals over five days in March 2022.

Discussion:

Frailty, identified in one-fifth of patients using tools like the Clinical Frailty Scale (CFS), was particularly common in emergency surgery and socioeconomically deprived groups.
While two-thirds of patients had multimorbidity, it only partially overlapped with frailty.
Frailty showed a strong association with increased length of stay, delirium, complications, and mortality, with outcomes worsening with higher CFS scores.

Key Insights:

Multimorbidity alone, without frailty, had a limited impact on most adverse outcomes.
Directed acyclic graphs were used for causal analysis, though potential underestimation of multimorbidity's impact exists due to independence assumptions.
The findings underscore the critical need for routine perioperative frailty screening and enhanced perioperative services.

Outlook:

Data from SNAP-3 will guide service planning and prioritize frailty-focused care, especially in high-burden specialties and deprived areas.
Workforce development is essential to support comprehensive perioperative care for frail patients.
Future research may explore the complex interplay between frailty and multimorbidity more deeply.