TY - JOUR
T1 - Perioperative frailty
T2 - Lessons learned and future directions
AU - Adeleke, Ibukunoluwa
AU - Blitz, Jeanna
N1 - Funding Information:
This work was supported by the Department of Anesthesiology, Duke University School of Medicine.
Publisher Copyright:
© 2021 Lippincott Williams and Wilkins. All rights reserved.
PY - 2021/6/1
Y1 - 2021/6/1
N2 - Purpose of reviewAs the surgical population ages, preoperative diagnosis and optimization of frailty becomes increasingly important. Various concepts are used to define frailty, and several tools have been validated for use in the perioperative period. This article reviews current conceptual frameworks of frailty, references current literature and provides a practical approach to the preoperative frailty assessment with a focus on potential interventions.Recent findingsA multipronged approach toward preoperative optimization should be used in patients with frailty syndrome. Oral protein supplementation and immunonutrition therapy can reduce complications in patients with malnutrition. Initiating a preoperative physical exercise regimen may mitigate frailty. Nonpharmacologic interventions to reduce preoperative anxiety and improve mood are effective, low-cost adjuncts associated with improvement in postoperative outcomes. Engaging in shared decision making is a critical component of the preoperative evaluation of frail patients.SummaryEmerging evidence suggests that frailty may be mitigated with patient-specific, multidimensional preoperative interventions, thus potentially improving postoperative outcomes in this vulnerable patient population.
AB - Purpose of reviewAs the surgical population ages, preoperative diagnosis and optimization of frailty becomes increasingly important. Various concepts are used to define frailty, and several tools have been validated for use in the perioperative period. This article reviews current conceptual frameworks of frailty, references current literature and provides a practical approach to the preoperative frailty assessment with a focus on potential interventions.Recent findingsA multipronged approach toward preoperative optimization should be used in patients with frailty syndrome. Oral protein supplementation and immunonutrition therapy can reduce complications in patients with malnutrition. Initiating a preoperative physical exercise regimen may mitigate frailty. Nonpharmacologic interventions to reduce preoperative anxiety and improve mood are effective, low-cost adjuncts associated with improvement in postoperative outcomes. Engaging in shared decision making is a critical component of the preoperative evaluation of frail patients.SummaryEmerging evidence suggests that frailty may be mitigated with patient-specific, multidimensional preoperative interventions, thus potentially improving postoperative outcomes in this vulnerable patient population.
KW - cognitive screening
KW - frailty
KW - nutritional supplementation
KW - prehabilitation
KW - psychological preparation
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U2 - 10.1097/ACO.0000000000001006
DO - 10.1097/ACO.0000000000001006
M3 - Review article
C2 - 33852505
AN - SCOPUS:85106069010
SN - 0952-7907
VL - 34
SP - 373
EP - 380
JO - Current opinion in anaesthesiology
JF - Current opinion in anaesthesiology
IS - 3
ER -