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Comment & Response
April 22, 2020

Implications of Preoperative Patient Frailty on Stratified Postoperative Mortality

Author Affiliations
  • 1Department of Surgery, Massachusetts General Hospital, Boston
  • 2Department of Physical Medicine and Rehabilitation, Massachusetts General Hospital, Boston
JAMA Surg. 2020;155(7):669-670. doi:10.1001/jamasurg.2020.0430

To the Editor The interesting study by Shinall et al1 used a novel operative stress score to classify surgical interventions by the amount of physiologic stress imposed on a patient. Irrespective of a procedure’s operative stress score, the authors established that patients who are deemed either frail or very frail, based on the Risk Analysis Index, have increased rates of postoperative mortality across all procedures. This work revealed that all procedures are essentially high risk for frail patients and that frailty screening should be universally implemented to more accurately predict postoperative mortality. While screening would serve to identify at-risk patients, how do we importantly improve outcomes for frail patients? A potential solution is prehabilitation.2

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