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International Journal of Colorectal Disease

, Volume 33, Issue 12, pp 1657–1666 | Cite as

Frailty in surgical patients

  • Simon J. G. Richards
  • Frank A. Frizelle
  • John A. Geddes
  • Tim W. Eglinton
  • Mark B. Hampton
Original Article
  • 89 Downloads

Abstract

Objective

To describe the current definitions, aetiology, assessment tools and clinical implications of frailty in modern surgical practice.

Background

Frailty is a critical issue in modern surgical practice due to its association with adverse health events and poor post-operative outcomes. The global population is rapidly ageing resulting in more older patients presenting for surgery. With this, the number of frail patients presenting for surgery is also increasing. Despite the identification of frailty as a significant predictor of poor health outcomes, there is currently no consensus on how to define, measure and diagnose this important syndrome.

Methods

Relevant references were identified through keyword searches of the Cochran, MEDLINE and EMbase databases.

Results

Despite the lack of a gold standard operational definition, frailty can be conceptualised as a state of increased vulnerability resulting from a decline in physiological reserve and function across multiple organ systems, such that the ability to withstand stressors is impaired. Multiple studies have shown a strong association between frailty and adverse peri-operative outcomes. Frailty may be assessed using multiple tools; however, the ideal tool for use in a clinical setting has yet to be identified. Despite the association between frailty and adverse outcomes, few interventions have been shown to improve outcomes in these patients.

Conclusion

Frailty encompasses a group of individuals at high risk of adverse post-operative outcomes. Further work exploring ways to optimally assess and target interventions towards these patients should be the focus of ongoing research.

Keywords

Frailty Post-operative outcomes Surgery Elderly 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.University of OtagoChristchurchNew Zealand
  2. 2.Department of SurgeryChristchurch HospitalChristchurchNew Zealand

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