Prevalence of pre-operative frailty and association with post-operative outcomes in patients presenting for elective major surgery: a single centre study 

Background: In Sri Lanka there is significant population aging. This has caused a significant increase in the prevalence of frailty among older adults. Frailty could impact surgical outcomes, which include postoperative complications and mortality. Even though it is important to assess frailty before surgery, this is not widely integrated into routine clinical practice.Objectives: This study aimed to evaluate the prevalence of frailty among patients who had undergone major surgeries at Teaching Hospital, Peradeniya.Methodology: This was a prospective observational study, which was conducted at Teaching Hospital, Peradeniya. The study included 157 patients aged 18 and above who underwent elective major surgeries. Frailty was assessed using the FRAIL scale, and data were analyzed using SPSS.Results: Among 157 participants, 77.1% were classified as pre-frail and 8.3% as frail based on the FRAIL scale. Surgical specialties included general surgery (23.6%), gynaecology (45.2%), orthopedics (19.1%), vascular (8.9%), and plastic surgery (3.2%). Frail patients had a longer duration of stay and a higher number of ICU admissions when compared to pre frail patients, which was statistically significant (p<0.05). There was a higher mortality in the frail group, but this was not found to be statistically significant.Conclusion: In our study, we highlight the significant prevalence of pre-frailty and frailty among surgical patients at Teaching Hospital Peradeniya, which was associated with increased length of stay and ICU admissions. Early identification of frailty among older patients can facilitate optimized management and improved surgical outcomes and patient safety.