Recommendations for Preoperative Management of Frailty from the Society for Perioperative Assessment and Quality Improvement (SPAQI)

J Clin Anesth. 2018 Jun:47:33-42. doi: 10.1016/j.jclinane.2018.02.011. Epub 2018 Mar 15.

Abstract

Frailty is an age-related, multi-dimensional state of decreased physiologic reserve that results in diminished resiliency and increased vulnerability to stressors. It has proven to be an excellent predictor of unfavorable health outcomes in the older surgical population. There is agreement in recommending that a frailty evaluation should be part of the preoperative assessment in the elderly. However, the consensus is still building with regards to how it should affect perioperative care. The Society for Perioperative Assessment and Quality Improvement (SPAQI) convened experts in the fields of gerontology, anesthesiology and preoperative assessment to outline practical steps for clinicians to assess and address frailty in elderly patients who require elective intermediate or high risk surgery. These recommendations summarize evidence-based principles of measuring and screening for frailty, as well as basic interventions that can help improve patient outcomes.

Keywords: Assessment; Frailty; Outcomes; Preoperative; Screening; Tool.

MeSH terms

  • Aged
  • Anesthesiology / methods*
  • Anesthesiology / standards
  • Elective Surgical Procedures / adverse effects*
  • Evidence-Based Medicine / methods
  • Evidence-Based Medicine / standards
  • Female
  • Frail Elderly
  • Frailty / diagnosis*
  • Humans
  • Male
  • Perioperative Care / methods*
  • Perioperative Care / standards
  • Postoperative Complications / etiology
  • Postoperative Complications / prevention & control
  • Prognosis
  • Quality Improvement*
  • Risk Assessment / methods
  • Risk Assessment / standards
  • Sex Factors