# Frailty

> Frailty is a state of reduced physiological reserve across multiple systems, leaving a patient vulnerable to stressors such as surgery. It independently predicts post-operative complications, longer stays, loss of independence and mortality — over and above age, ASA class or the specific procedure — which is why it is screened separately before elective surgery.

*Source: https://getpathways.ai/glossary/frailty*

Also known as: perioperative frailty, frailty syndrome

- **Definition**: Reduced physiological reserve across multiple systems
- **Predicts**: Complications, length of stay, loss of independence, mortality
- **Independent of**: Chronological age, ASA class, procedure type
- **Related measure**: Functional capacity (METs)

## Why it is screened separately

The intuition that frailty is a proxy for age is wrong often enough to be
dangerous in both directions. A robust 84-year-old and a frail 68-year-old have
substantially different perioperative risk profiles, and neither is captured by
age or by ASA class — a frail patient may well be classified ASA 2.

Because frailty predicts outcomes that matter to patients as much as to services
— particularly loss of independence and discharge destination — it also changes
the shape of the pre-operative conversation, not just the anaesthetic plan.

## Where it fits in the assessment

Functional capacity and frailty is one of the 12 domains covered in the Socrates
Pre-Op interview. Screening it on every patient rather than on those who look
frail is the point: the patients whose reserve is quietly depleted are exactly
the ones who present well in a short phone call.