Frailty should be assessed before surgery

The surgical population is ageing, and preoperative surgical evaluation is limited in its risk prediction ability of perioperative complications. Increasing age results in an increased risk of frailty. Guidelines suggest that frailty should be assessed before surgery. Different frailty scales are described as suggestions for risk-stratification. The frail patient should be offered shared decision-making prior to surgery. Preoperative optimisation programs, i.e. prehabilitation, may benefit patients with frailty, but further research studies examining these perspectives are warranted, as argued in this review.