The utility of preoperative frailty assessment

Purpose of review The geriatric patient population represents an ever increasing proportion of a surgeon’s practice spectrum. With this comes the need to understand the factors largely impacting the geriatric surgical population. One of these factors is frailty. At first glance frailty appears as a simple concept. However, a review of the literature reveals a plethora of definitions, quantification endeavors, and theories attempting to delineate its principle attributes. Recent findings Despite the variety of theories, the literature supports a strong link between frailty and poor surgical outcomes. While this link is strong, the exact utility of frailty in preoperative assessments is still being appreciated both in the general surgery setting and in its subspecialties. Summary In this review we first discuss the background and defining attributes of frailty and their relation to concepts closely associated with frailty such as resilience, multi-morbidity, and accelerating factors of aging. Understanding the prominent defining features and close associ-ations allows for a greater appreciation of frailty’s clinical impact on the geriatric perioperative surgical assessment. Ultimately, when including frailty in the geriatric surgical assessment its consideration allows for modification in the preoperative, intraoperative, and postoperative setting with the overall goal of improving surgical outcomes in the geriatric population.