The Prognostic Value of Automatic Frailty Assessment : Anesthesia & Analgesia

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The Prognostic Value of Automatic Frailty Assessment

Nathan, Naveen MD

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Anesthesia & Analgesia 133(5):p 1089, November 2021. | DOI: 10.1213/ANE.0000000000005772
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Patient frailty is often ill-defined but critically influential within the context of outcomes after surgery. Currently, there is inconsistent characterization, assessment, and risk stratification of patients presenting for surgery in terms of frailty. The infographic summarizes the findings of a systematic review and meta-analysis in which electronic health records were mined for frailty assessments. These characterizations were pooled to observe any notable association with postoperative mortality risk and other secondary outcomes. The authors demonstrated that automated frailty assessments predicted a 3-fold risk of mortality, heightened chances of nonhome discharge, and increased costs. The authors are astute to point out that frailty is an extremely complex concept to study, owing to the inconsistency of different frailty instruments (most are not multidimensional), lack of head-to-head comparisons between instruments, and lack of feasibility data. Further studies addressing these areas of uncertainty will better define our understanding of frailty assessment and its importance for patient outcomes.


confidence interval
electronic health records
odds ratio
ratio of means.


1. Alkadri J, Hage D, Nickerson LH, et al. A systematic review and meta-analysis of preoperative frailty instruments derived from electronic health data. Anesth Analg. 2021;133: 1094–1106.
2. Whitlock EL. Frailty: more than the sum of its parts? Anesth Analg. 2021;133:1090–1093.
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