Preoperative Assessment of Frailty Lowered Postoperative Mortality

The known association of frailty with excess risk for postoperative complications and mortality prompted investigators at a major U.S. integrated health system to assess whether requisite preoperative frailty assessment was beneficial. The validated frailty index incorporated demographic characteristics, medical comorbidities, weakness, fatigue, slowness, and cognitive function (maximum score, 81). A Best Practice Advisory was placed in the electronic health record; frailty scores ≥42 triggered a stop that required surgeons to re-evaluate the benefits of elective surgery and, if continuing, to engage in frailty-informed shared decision making or to refer patients for further evaluation from either primary care or a multidisciplinary preoper…