November 15, 2017 – Preoperative Frailty


Anchor lead: Frailty should be considered before any operation in an older person, Elizabeth Tracey reports

Frailty is not just an adjective but a measureable health metric that should be employed before any older person has surgery, a recent study asserts. Kevin Gerold, an anesthesiologist at Johns Hopkins, agrees.

Gerold: I think the frailty score is a very good idea. I don’t think it’s so much whether they should have an operation or not but it may dictate the objective of the surgery. The concept of frailty relates to the inevitable decline of physiologic reserve that occurs as a normal consequence of aging. We need to consider that a healthy 60 or 70 year old is not the same as a healthy forty year old.  When faced with the need to have surgery, the concept really is more what is the objective?  :28

Gerold notes that frailty can be simply assessed with a walking test, with very slow walk speed or an inability to walk very far giving a good approximation, but says the development of other assessments is underway. He says both patient and loved ones should consider the likely outcome of surgery before a procedure is undertaken, especially in the frail. At Johns Hopkins, I’m Elizabeth Tracey.