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
Identify all potential conflicts of interest that might be relevant to your comment.
Conflicts of interest comprise financial interests, activities, and relationships within the past 3 years including but not limited to employment, affiliation, grants or funding, consultancies, honoraria or payment, speaker's bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued.
Err on the side of full disclosure.
If you have no conflicts of interest, check "No potential conflicts of interest" in the box below. The information will be posted with your response.
Not all submitted comments are published. Please see our commenting policy for details.
Sell NM, Qadan M, Silver JK. Implications of Preoperative Patient Frailty on Stratified Postoperative Mortality. JAMA Surg. 2020;155(7):669–670. doi:10.1001/jamasurg.2020.0430
Coronavirus Resource Center
Customize your JAMA Network experience by selecting one or more topics from the list below.
Create a personal account or sign in to: