RT Journal Article
SR Electronic
T1 Frailty in the perioperative setting
JF Clinical Medicine
JO Clin Med
FD Royal College of Physicians
SP 485
OP 489
DO 10.7861/clinmed.2019-0283
VO 19
IS 6
A1 Jugdeep K Dhesi
A1 Nicholas P Lees
A1 Judith SL Partridge
YR 2019
UL http://www.rcpjournals.org/content/19/6/485.abstract
AB The frailty syndrome is defined as a decrease in physiological reserve across multiple organ systems leading to increased vulnerability to external stressors. Studies across surgical subspecialties and in emergency and elective settings have identified frailty as an independent predictor of adverse postoperative clinician-reported, patient-reported and process-related outcomes. Although frailty is not specific to the older population, it is associated with ageing and therefore is increasingly observed in the ageing surgical population. Identifying frailty early in the perioperative pathway affords the opportunity to assess risk, modify the syndrome, inform shared decision making and plan the surgical pathway. Multiple tools to screen and diagnose frailty exist with limited appraisal of clinometric properties. A pragmatic approach to these tools is advocated with a future focus on collaborative approaches to modify the syndrome using multicomponent methodology such as comprehensive geriatric assessment and adapt the pathway to the needs of the frail surgical patient.