The role of frailty and prehabilitation in surgery

Kamil Hanna, Michael Ditillo, Bellal Joseph

Research output: Contribution to journalReview articlepeer-review

46 Scopus citations

Abstract

Purpose of reviewThe aging surgical population constitutes a unique challenge to clinicians across the spectrum of care. Frailty is a valuable tool for preoperative risk stratification and may guide targeted interventions, such as prehabilitation. The aim of this review is to revise the recent literature on the role of frailty and prehabilitation to optimize geriatric patients undergoing surgery.Recent findingsThe concept of frailty became more refined over the past couple of decades, and its various dimensions have been operationalized into an array of different frailty scoring systems. The association between frailty and adverse perioperative events has been demonstrated in many surgical specialties. The use of multimodal prehabilitation of frail patients is expanding, and most prehabilitation programs (which focus on nutritional supplementation, feedback-based exercise regimens, and pulmonary optimization) have promising outcomes.SummaryFrailty is a valuable risk stratification tool that better captures the state of augmented vulnerability of older adults. Frail patients benefit from targeted interventions, such as multimodal prehabilitation. Thus, the implementation of nationwide geriatric surgery standards can address ongoing challenges in performing surgery on older, frail patients.

Original languageEnglish (US)
Pages (from-to)717-722
Number of pages6
JournalCurrent opinion in critical care
Volume25
Issue number6
DOIs
StatePublished - Dec 1 2019

Keywords

  • aging
  • frailty
  • frailty index
  • geriatrics
  • prehabilitation

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

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