Optimal frailty index tools for surgical risk assessment: A systematic review

This is the authors' abstract. We don't add key points for this paper.

Frailty syndrome, characterized by age-associated declines in physiological reserve and function across multiple organ systems, poses a significant challenge to geriatric healthcare. The prevalence of frailty ranges widely, affecting up to 59.1% of older adults, especially those aged 65–74 and over 75. Among the numerous frailty assessment tools examined, Fried's Frailty Phenotype, Edmonton Frail Scale (EFS), Clinical Frailty Scale (CFS), Groningen Frailty Indicator (GFI), and Frailty Index (FI) emerged as the most utilized in clinical practice. Each tool's ability to assess frailty in relation to surgical outcomes was evaluated, highlighting the need for tools that are quick, easy to implement, and capable of detecting multiple risk factors. The EFS is presented as a particularly effective frailty screening tool, balancing high sensitivity with rapid administration and ease of use by non-medical staff. Its application in surgical settings can aid in identifying frail patients early, leading to optimized preoperative management and improved surgical outcomes. Recognizing frailty in surgical patients is vital to enhance safety, ensure appropriate surgical interventions, and promote better recovery post-surgery. This review aims to compare selected frailty assessment tools to identify the most effective instruments for pre-surgical risk stratification, ultimately improving preoperative care and reducing postoperative complications.