Frailty and anaesthesia
Keywords:
anaesthesia, frailty, outcomes, perioperative, clinical frailty scale, riskAbstract
Frailty is defined as a state of vulnerability due to reduced physiological reserve that predisposes patients to adverse outcomes from a stressor. It is a multidimensional state where reduced biological reserves interplays with cognitive factors, psychosocial factors and the external environment, resulting in reduced resilience and adaptive capacity. This clinical syndrome confers a higher risk for falls, hospitalisation, readmission, disability, loss of functional independence and death. Preoperative frailty screening assesses domains outside traditional risk measures and can add prognostic value. Identifying frail patients allows the opportunity for optimisation and prehabilitation, risk prediction, shared decision making, implementation of enhanced care pathways and appropriate intensive care resource allocation in an attempt to mitigate risk, thereby improving outcomes. Anaesthetists need to be familiar with the unique challenges in this patient group in order to offer high quality perioperative care.
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