Preoperative frailty assessment

Frailty criteria	Assessment	Score				Points
Shrinkage	Ask the patient: Have you unintentionally lost ≥10 lbs in the past year? Yes / No	If Yes, add 1 point
Weakness (grip strength)	Ask the patient to hold dynamometer in dominant hand with arms parallel to their body without squeezing arms against their body. Adjust the handle to ensure that the middle phalanx rests on the inner handle. Ask the patient to squeeze the handle and record. Perform three trials, and obtain the average value. Record results below: Trial 1: ________ kg force Trial 2: ________ kg force Trial 3: ________ kg force Average: ________ kg force	Compare patient's average with the lowest 20th percentile by gender and BMI shown below:
		Men		Women
		BMI	Kg force	BMI	Kg force
		≤24	≤29	≤23	≤17
		24.1 to 26	≤30	23.1 to 26	≤17.3
		26.1 to 28	≤31	26.1 to 29	≤18
		>28	≤32	>29	≤21
		Add 1 point if the average falls within or below the above values
Exhaustion	Ask the patient the following two questions: How often in the last week did you feel that everything you did was an effort? ________ How often in the last week did you feel that you could not get going? ________
		0	1	2	3
		Rarely or none of the time (<1 day)	Some or a little of the time (1 to 2 days)	Moderate amount of the time (3 to 4 days)	Most of the time (>4 days)
		Add 1 point for a score of 2 or 3 for EITHER question
Low physical activity	Ask the patient the following four questions: Can you get out of bed or chair yourself? Yes / No Can you dress and bathe yourself? Yes / No Can you make your own meals? Yes / No Can you do your own shopping? Yes / No	Add 1 point for any No answer
Slowness	Ask the patient to stand up and walk toward the tape on the ground. Using a stopwatch, record the time it takes for the patient to walk 15 feet. Record results below: Trial: ________ seconds
		Men		Women
		Height	Time	Height	Time
		≤173 cm	≥7 seconds	≤159 cm	≥7 seconds
		>173 cm	≥6 seconds	>159 cm	≥6 seconds
		Add 1 point if the trial time falls higher than the above values
Frailty score:

Total the number of points for each criterion (the total should be 0 to 5) to determine the frailty score.

0 to 1: Not frail
2 to 3: Intermediate (pre-frail)
4 to 5: Frail

If the patient is in the intermediate frail or frail categories, please notify the surgeon.

BMI: body mass index.

Adapted from:

Fried LP, Tangen CM, Walston J, et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci 2001; 56:M146.
Frailty. In: Geriatrics Evaluation & Management Tools: Clinical Templates to Support Clinicians and Systems that are Caring for Older Adults, American Geriatrics Society, New York 2013.

Graphic 114174 Version 1.0

خرید پکیج

Preoperative frailty assessment