Why the study?
Preoperative frailty increases postoperative morbidity and mortality in older cancer patients, but the gold standard full Geriatric Assessment requires time and experience, and no single ideal screening tool exists.
Preoperative frailty evaluations are crucial for older cancer patients undergoing high-risk surgery, and various screening tools exist as alternatives to the time-consuming full Geriatric Assessment.
May warrant preoperative frailty evaluations before high-risk cancer surgery; leaves open impact on outcomes without prospective trials.
At present there is strong evidence demonstrating that not chronological age, but the presence of frailty before surgery is associated with a significant increase in postoperative morbidity, mortality, along with increased risk of delirium, disability, increased length of hospital stay and resource use. Therefore, preoperative frailty evaluations should become obligatory prior to high-risk surgery of older patients suffering from cancer. Currently, the golden standard is the full Geriatric Assessment. However, it requires time and, first of all, experience. Various simple frailty screening tools have been developed,, however, currently there is no single ideal one. Therefore, there is a constant search for the “holy grail” of preoperative geriatric evaluations. The Tilburg Frailty Indicator, the Edmonton Frail Scale, the Cardiovascular Health Study index, the Clinical Frailty Scale, the Study of Osteoporotic Fractures index and Frailty Index are examples of evaluation tools that have some features of screening scores and the full Geriatric Assessment. In the present article they were characterised briefly to familiarize the reader with the advantages and disadvantages of each.
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Jakub Kenig (2020) studied this question.
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