• Jugdeep K Dhesi, Nicholas P Lees, and Judith Sl Partridge.
• Guy's and St Thomas' NHS Foundation Trust, London, UK, honorary reader, Faculty of Life Sciences and Medicine, King's College London, London, UK and honorary associate professor, Division of Surgery & Interventional Science, University College London, London, UK jugdeep.dhesi@gstt.nhs.uk.
• Clin Med (Lond). 2019 Nov 1; 19 (6): 485489485-489.

AbstractThe frailty syndrome is defined as a decrease in physiological reserve across multiple organ systems leading to increased vulnerability to external stressors. Studies across surgical subspecialties and in emergency and elective settings have identified frailty as an independent predictor of adverse postoperative clinician-reported, patient-reported and process-related outcomes. Although frailty is not specific to the older population, it is associated with ageing and therefore is increasingly observed in the ageing surgical population. Identifying frailty early in the perioperative pathway affords the opportunity to assess risk, modify the syndrome, inform shared decision making and plan the surgical pathway. Multiple tools to screen and diagnose frailty exist with limited appraisal of clinometric properties. A pragmatic approach to these tools is advocated with a future focus on collaborative approaches to modify the syndrome using multicomponent methodology such as comprehensive geriatric assessment and adapt the pathway to the needs of the frail surgical patient.© 2019 Royal College of Physicians.

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