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Frailty in the Geriatric Trauma Patient: a Review on Assessments, Interventions, and Lessons from Other Surgical Subspecialties

  • Geriatric Trauma (B Joseph, Section Editor)
  • Published:
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Abstract

Purpose of Review

The elderly population is increasing and as a result more older adults are requiring hospitalization for illnesses and injuries. Prognosis in the geriatric population is impacted not only by age, but also by underlying physiologic reserve. In this review, we will summarize recent research on this topic, including assessments and scales to characterize frailty, interventions based on frailty assessments, and unique circumstances of frailty in subsets of surgical patients to help define and characterize efforts to minimize in-hospital mortality, loss of functional independence, and non-home discharge for the frail patient.

Recent Findings

There are three commonly recognized approaches to defining frailty. Scoring systems typically include some combination of scored components such as self-reported functionality, objective measures of physical function, and metrics for overall health. Recent research on interventions in frailty is centered on combining previous evidence-based interventions into bundles via multidisciplinary consultations and multifaceted interventions. With increasing recognition of frailty as a marker for poor outcomes, various surgical subspecialties have investigated how to target frailty as a modifiable risk factor in patients to improve peri-operative mortality and decrease rates of complications.

Summary

Frailty in the surgical patient is an evolving concept with a rapidly evolving body of research. There are numerous ways to diagnose and classify this syndrome, and multiple interventions that have been proven to combat the effects on this cohort of patients. In designing future studies, more work is needed in early characterization of frailty and risk-stratification for those at risk of poor outcomes in order to allot resources early and appropriately for best results.

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Funding

HRK is supported by the National Institute of General Medical Sciences of the National Institutes of Health (5T32GM008792).

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Authors and Affiliations

  1. Division of Acute Care Surgery, Department of Surgery, McGovern Medical School at UTHealth, Houston, TX, USA

    Heather R. Kregel, Thaddeus J. Puzio & Sasha D. Adams

  2. Center for Surgical Trials and Evidence-Based Practice, McGovern Medical School at UTHealth, Houston, TX, USA

    Heather R. Kregel

  3. Center for Translational Injury Research, Houston, TX, USA

    Heather R. Kregel, Thaddeus J. Puzio & Sasha D. Adams

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Kregel, H.R., Puzio, T.J. & Adams, S.D. Frailty in the Geriatric Trauma Patient: a Review on Assessments, Interventions, and Lessons from Other Surgical Subspecialties. Curr Trauma Rep 8, 237–245 (2022). https://doi.org/10.1007/s40719-022-00241-5

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