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Special Communication |

Summary of the Panel Session at the 38th Annual Surgical Symposium of the Association of VA Surgeons What Is the Big Deal About Frailty?

Daniel A. Anaya, MD1,2,3; Jason Johanning, MD4,5; Seth A. Spector, MD6; Mark R. Katlic, MD7; Albert C. Perrino, MD8,9; Jessica Feinleib, MD, PhD8,9; Ronnie A. Rosenthal, MD, MS10,11
[+] Author Affiliations
1Houston VA Center for Innovations in Quality, Effectiveness and Safety (IQUEST), Michael E. DeBakey VA Medical Center, Houston, Texas
2Operative Care Line, Michael E. DeBakey VA Medical Center, Houston, Texas
3Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas
4Operative Care Line, Nebraska–Western Iowa VA Medical Center, Omaha
5Department of Surgery, University of Nebraska Medical Center, Omaha
6Operative Care Line, Miami VA Healthcare System, Miami, Florida
7Sinai Center for Geriatric Surgery, Department of Surgery, Sinai Hospital, Baltimore, Maryland
8Department of Anesthesiology, VA Connecticut Healthcare System, New Haven
9Yale University School of Medicine, New Haven, Connecticut
10Surgical Service, VA Connecticut Healthcare System, New Haven
11Department of Surgery, Yale University School of Medicine, New Haven, Connecticut
JAMA Surg. 2014;149(11):1191-1197. doi:10.1001/jamasurg.2014.2064.
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Owing to the phenomenon known as “global graying,” elderly-specific conditions, including frailty, will become more prominent among patients undergoing surgery. The concept of frailty, its effect on surgical outcomes, and its assessment and management were discussed during the 38th Annual Surgical Symposium of the Association of VA Surgeons panel session entitled “What’s the Big Deal about Frailty?” and held in New Haven, Connecticut, on April 7, 2014. The expert panel discussed the following questions and topics: (1) Why is frailty so important? (2) How do we identify the frail patient prior to the operating room? (3) The current state of the art: preoperative frail evaluation. (4) Preoperative interventions for frailty prior to operation: do they work? (5) Intraoperative management of the frail patient: does anesthesia play a role? (6) Postoperative care of the frail patient: is rescue the issue? This special communication summarizes the panel session topics and provides highlights of the expert panel’s discussions and relevant key points regarding care for the geriatric frail surgical patient.

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Algorithm for Perioperative Assessment of Frailty, and Highlights and Existing Knowledge Gaps, as Discussed During the Frailty Panel Session
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