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Frailty in the older person undergoing elective surgery: a trigger for enhanced multidisciplinary management - a narrative review

Citation

Subramaniam, A and Tiruvoipati, R and Lodge, M and Moran, C and Srikanth, V, Frailty in the older person undergoing elective surgery: a trigger for enhanced multidisciplinary management - a narrative review, ANZ Journal of Surgery, 90, (3) pp. 222-229. ISSN 1445-1433 (2020) [Refereed Article]

Copyright Statement

Copyright 2020 Royal Australasian College of Surgeons

DOI: doi:10.1111/ans.15633

Abstract

Background: The ageing of our society has led to increasing numbers of older people requiring elective surgical procedures. Preoperative frailty is a strong predictor of adverse post-operative outcomes. This review aims to summarize the evidence for interventions aimed at improving outcomes in frail older people who may undergo elective surgery.

Methods: Articles published on perioperative management of frailty between 1 January 1970 and 31 May 2019 were searched using PubMed and EMBASE.

Results: We identified very few studies investigating such interventions, such as comprehensive geriatric assessment, prehabilitation (alone or as a multicomponent strategy) and other multicomponent interventions. Administration of a comprehensive geriatric assessment was shown to be associated with reduced mortality, fewer complications and shorter length of hospital stay, and may be best targeted towards those who are identified as frail for resource efficiency. Multicomponent interventions including prehabilitation may be associated with improved outcomes, but the evidence base for these needs to be strengthened.

Conclusion: Establishing multidisciplinary collaborative services to provide person-centred models of care should be considered for older people presenting for elective surgery, particularly in those with greater preoperative frailty. Further large-scale studies should focus on implementing and evaluating such multicomponent models of care.

Item Details

Item Type:Refereed Article
Keywords:comprehensive geriatric assessment, elderly, frail, frailty, perioperative medicine, prehabilitation, surgery
Research Division:Biomedical and Clinical Sciences
Research Group:Clinical sciences
Research Field:Geriatrics and gerontology
Objective Division:Health
Objective Group:Specific population health (excl. Indigenous health)
Objective Field:Health related to ageing
UTAS Author:Srikanth, V (Dr Velandai Srikanth)
ID Code:138873
Year Published:2020
Web of Science® Times Cited:3
Deposited By:Menzies Institute for Medical Research
Deposited On:2020-05-06
Last Modified:2021-03-16
Downloads:0

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