Surgical frailty assessment: a missed opportunity

Eamer, G., Gibson, J. A., Gillis, C., Hsu, A. T., Krawczyk, M. , MacDonald, E., Whitlock, R. and Khadaroo, R. G. (2017) Surgical frailty assessment: a missed opportunity. BMC Anesthesiology, 17, 99. (doi: 10.1186/s12871-017-0390-7) (PMID:28738809) (PMCID:PMC5525360)

Abstract

Background: Preoperative frailty predicts adverse postoperative outcomes. Despite the advantages of incorporating frailty assessment into surgical settings, there is limited research on surgical healthcare professionals’ use of frailty assessment for perioperative care. Methods: Healthcare professionals caring for patients enrolled at a Canadian teaching hospital were surveyed to assess their perceptions of frailty, as well as attitudes towards and practices for frail patients. The survey contained open-ended and 5-point Likert scale questions. Responses were compared across professions using independent sample t-tests and correlations between survey items were analyzed. Results: Nurses and allied health professionals were more likely than surgeons to think frailty should play a role in planning a patient’s care (nurses vs. surgeons p = 0.008, allied health vs. surgeons p = 0.014). Very few respondents (17.5%) reported that they ‘always used’ a frailty assessment tool. Results from qualitative data analysis identified four main barriers to frailty assessment: institutional, healthcare system, professional knowledge, and patient/family barriers. Conclusion: Across all disciplines, the lack of knowledge about frailty issues was a prominent barrier to the use of frailty assessments in practice, despite clinicians’ understanding that frailty affects their patients’ outcomes. Confidence in frailty assessment tool use through education and addressing barriers to implementation may increase use and improve patient care. Healthcare professionals agree that frailty assessments should play a role in perioperative care. However, few perform them in practice. Lack of knowledge about frailty is a key barrier in the use of frailty assessments and the majority of respondents agreed that they would benefit from further training.

• Item Type: Articles
• Additional Information: GE, JG, CG, ATH, MK, EM and RW were all funded by the Canadian Frailty Network Interdisciplinary Fellowship and conducted the research as part of the Online Collaborative Project.
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Krawczyk, Dr Marian
• Authors: Eamer, G., Gibson, J. A., Gillis, C., Hsu, A. T., Krawczyk, M., MacDonald, E., Whitlock, R., and Khadaroo, R. G.
• College/School: College of Social Sciences > School of Social & Environmental Sustainability
• Journal Name: BMC Anesthesiology
• Publisher: BioMed Central
• ISSN: 1471-2253
• ISSN (Online): 1471-2253
• Copyright Holders: Copyright © 2017 The Authors
• First Published: First published in BMC Anesthesiology 17:99
• Publisher Policy: Reproduced under a Creative Commons License