Frailty and social support in older orthopedic surgical patients: a cross-sectional analysis

Frailty is a common and clinically significant condition among older adults undergoing surgical procedures and is associated with adverse postoperative outcomes. In addition to biological vulnerability, psychosocial factors such as social support may influence recovery processes. However, studies examining the relationship between frailty and perceived social support in older orthopedic surgical patients remain limited.

This study aimed to examine the relationship between frailty and perceived social support in older orthopedic surgical patients and to determine how these variables differ according to sociodemographic and clinical characteristics.

This cross-sectional study was conducted with 241 older orthopedic surgical patients aged 65 years and older who underwent orthopedic surgical procedures. Data were collected using the Descriptive Characteristics Form, the Edmonton Frail Scale, and the Multidimensional Scale of Perceived Social Support. Descriptive statistics, independent samples t-tests, one-way ANOVA, and Spearman correlation analysis were used. A p value of < 0.05 was considered statistically significant.

Participants showed clinically relevant levels of frailty, with many classified as mildly, moderately, or severely frail, and reported moderate to high levels of perceived social support. Social support was highest from family and lowest from a significant other. A substantial proportion of patients were identified as having mild, moderate, or severe frailty. No significant relationship was found between total perceived social support and frailty; however, family support was significantly and inversely associated with frailty (p < 0.05). Frailty levels were significantly higher among female participants and those with lower educational levels (p < 0.05).

Frailty remains a prevalent condition among older orthopedic surgical patients, even in the presence of relatively high levels of perceived social support. Family-based support was significantly and inversely associated with frailty; however, this finding should be interpreted as an association rather than evidence of a protective or causal effect. Integrating frailty screening with the assessment of social support in perioperative care may support the development of individualized and patient-centered nursing interventions. Future studies should explore causal relationships using longitudinal designs and include detailed clinical variables such as surgical type.