Frailty in anesthesia

PURPOSE OF REVIEW: Due to demographic change, the number of geriatric patients is increasing in the surgical field. This poses a major challenge in perioperative medicine. In order to improve patient safety, frailty has become a key element for risk assessment in the perioperative setting. This review aims to summarize the current state of anesthesia in frail patients. RECENT FINDINGS: Frailty is an independent risk factor for intraoperative and postoperative complications, mortality, and length of hospital stay. The Clinical Frailty Scale has been shown to be a feasible, easy-to-use tool for frailty assessment. Frailty is likely to be modified through targeted preoperative optimization (prehabilitation). This should be carried out on a multidisciplinary basis. During preoperative risk assessment, special attention should be paid to polypharmacy and multimorbidity. Particularly in geriatric patients, maintaining intra- and postoperative homeostasis is essential. Adequate pain management and prevention of perioperative delirium are of utmost importance. SUMMARY: Frailty is a common and highly relevant clinical risk factor in the perioperative setting. In future, efforts should focus on identifying methods to improve the status of preoperative frail patients.