Frailty assessment tools and their predictive value in preoperative evaluation for general surgery: a narrative review

The world’s population is ageing rapidly, with projections suggesting a significant increase in the elderly demographic over the next few decades. This shift is likely to result in long periods of infirmity and frailty, thus escalating healthcare demands. Frailty has been investigated almost exclusively in the elderly because of its association with the senior population. It is considered to be an unavoidable aspect of old age, rather than a variable aspect of ageing. It has been linked to a greater risk of falls and decreased mobility, increased hospitalizations, institutionalization, and mortality. Due to elevated complication risk, the frail group required expert surgical treatment and specialised care. Various models have been described in recent years, including the Frailty Phenotype model, the Edmonton Frailty scale, and the Clinical Frailty scale, among many others. Each model employs several components to assess an individual’s frailty. There is, however, no gold standard for measuring fragility. The use of such assessment methods in pre-operative frailty screening as a risk-stratification instrument has been shown to be effective in older persons undergoing general surgery. The use of frailty assessment tools to determine the level of frailty together with evidence-based treatment and management should be supported by collaborative decision making. In this narrative review, we discussed the four commonly used frailty assessment tools with a particular emphasis on the need for additional research to refine these models and enhance their predictive accuracy in surgical settings.