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Frailty in the older person undergoing elective surgery: a trigger for enhanced multidisciplinary management - a narrative review
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.
Publication titleANZ Journal of Surgery
Department/SchoolMenzies Institute for Medical Research
PublisherBlackwell Publishing Asia
Place of publication54 University St, P O Box 378, Carlton, Australia, Victoria, 3053
Rights statementCopyright 2020 Royal Australasian College of Surgeons