The perioperative management of frailty in patients presenting for vascular surgery

Abstract

The volume of patients who are older and living with frailty presenting for surgery is increasing. Frailty is a multifactorial clinical syndrome associated with decreased metabolic and physiological reserve across multiple organ systems. Frailty increases vulnerability to morbidity, loss of independence, and death in the perioperative period. Data suggest that frailty is prevalent within the vascular surgical population, itself a high-risk group. As a result, identifying patients living with frailty presenting for vascular surgery is of utmost importance. In this article, we discuss what is currently known about the burden of frailty in the vascular surgical population, how to identify those living with frailty preoperatively, the optimization of frailty, and their intra- and postoperative care.