Patient frailty: the elephant in the operating room

Hubbard, R. E. and Story, D. A. (2014) Patient frailty: the elephant in the operating room. Anaesthesia, 69 Supplement s1: 26-34. doi:10.1111/anae.12490

Author Hubbard, R. E.
Story, D. A.
Title Patient frailty: the elephant in the operating room
Journal name Anaesthesia   Check publisher's open access policy
ISSN 0003-2409
Publication date 2014-01-01
Year available 2013
Sub-type Critical review of research, literature review, critical commentary
DOI 10.1111/anae.12490
Open Access Status Not yet assessed
Volume 69
Issue Supplement s1
Start page 26
End page 34
Total pages 9
Place of publication Chichester, West Sussex, United Kingdom
Publisher Wiley-Blackwell
Language eng
Abstract For most surgeons and many anaesthetists, patient frailty is currently the ‘elephant in the (operating) room’: it is easy to spot, but is often ignored. In this paper, we discuss different approaches to the measurement of frailty and review the evidence regarding the effect of frailty on peri-operative outcomes. We explore the limitations of ‘eyeballing’ patients to quantify frailty, and consider why the frail older patient, challenged by seemingly minor insults in the postoperative period, may suffer falls or delirium. Frailty represents a state of increased vulnerability to stressors, and older inpatients are exposed to multiple stressors in the peri-operative setting. Quantifying frailty is likely to increase the precision of peri-operative risk assessment. The Frailty Index derived from Comprehensive Geriatric Assessment is a simple and robust way to quantify frailty, but is yet to be systematically investigated in the pre-operative setting. Furthermore, the optimal care for frail patients and the reversibility of frailty with prehabilitation are fertile areas for future research.
Keyword Anesthesiology
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Article first published online: 5 December 2013.

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
Collections: Official 2014 Collection
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