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