For those of us seeing surgical patients during the perioperative journey, the recent findings from NAP71 provided the figures for something we already recognised. The surgical cohort is older and more co-morbid than ever before. Increased frailty was associated with perioperative complications, with pre-operative risk assessment being especially poorly recorded in highly frail patients.

Recognising frailty in the pre-operative period allows us to provide better risk stratification and have meaningful shared decision-making conversations with patients with a higher potential for complications. It also allows for early intervention and surgical pathway planning2.

A number of simple tools are available to identify frailty, and this recent study from Australia highlights the robustness of the Clinical Frailty Scale, with a good correlation between users.


1. Soar, J. et al., 2023. NAP7 headlines and summary of key findings, London: Royal College of Anaesthetists, Centre for Research & Improvement.

2. Dhesi, J., Lees, N., Partridge, J. Frailty in the perioperative setting. Clinical Medicine. 2019. 19(6): 485-489.


Dr Samantha Moore, CPOC Fellow