Is current preoperative frailty assessment adequate?

Is current preoperative frailty assessment adequate?

Can J Surg 2017;60(6):367-368 | PDF

Gilgamesh Eamer, MD, MSc; Jennifer A. Gibson, MSN; Chelsia Gillis, RD, MSc; Amy T. Hsu, PhD; Marian Krawczyk, PhD; Emily MacDonald, RN, MN; Reid Whitlock, MSc; Rachel G. Khadaroo, MD, PhD

Summary

Preoperative frailty predicts adverse postoperative outcomes. Recommendations for preoperative assessment of elderly patients include performing a frailty assessment. Despite the advantages of incorporating frailty assessment into surgical settings, there is limited research on surgical health care professionals’ perception and use of frailty assessment for perioperative care. We surveyed local health care employees to assess their attitudes toward and practices for frail patients. Nurses and allied health professionals were more likely than surgeons to agree frailty should play a role in planning a patient’s care. Lack of knowledge about frailty issues was a prominent barrier to the use of frailty assessments in practice, despite clinicians understanding that frailty affects their patients’ outcomes. Results of this survey suggest further training in frailty issues and the use of frailty assessment instruments is necessary and could improve the uptake of such tools for perioperative care planning.


Accepted Apr. 5, 2017; Early-released Oct. 1, 2017

Acknowledgements: The authors acknowledge the support of the Canadian Frailty Network Interdisciplinary Fellowship Program.

Affiliations: From the Department of Surgery, University of Alberta, Edmonton, Alta. (Eamer, Khadaroo); the School of Public Health, University of Alberta, Edmonton, Alta. (Eamer); the School of Nursing, University of British Columbia, Vancouver, BC (Gibson); the Cumming School of Medicine, University of Calgary, Calgary, Alta. (Gillis); the Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ont. (Hsu); the Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, Ont. (Hsu); the Centre for Health Evaluation and Outcome Sciences, St. Paul’s Hospital, Vancouver, BC (Krawczyk); the Trinity Western University, Langley, BC (Krawczyk); the Department of Nursing and Health Sciences, University of New Brunswick, Saint John, NB (MacDonald); and the Department of Community Health Sciences, University of Manitoba, Winnipeg, Man. (Whitlock).

Competing interests: J. Gibson received training funding from the Canadian Frailty Network and is supported by the Government of Canada through the Networks of Centres of Excellence (NCE) Program; she has received travel assistance from these programs to attend academic conferences. No other competing interests declared.

Contributors: All authors contributed substantially to the conception, writing and revision of this article and approved the final version for publication.

DOI: 10.1503/cjs.001417

Correspondence to: R. Khadaroo, Department of Surgery, University of Alberta, 8440-112 St, 2D Walter MacKenzie Centre, Edmonton AB T6G 2B7 khadaroo@ualberta.ca