The perioperative management of frailty in patients presenting for vascular surgery

A high number of patients are living with frailty and increasing numbers are presenting for major surgery. Frailty is a multifactorial clinical syndrome associated with decreased metabolic and physiological reserve across multiple organ systems. This increases vulnerability to morbidity, loss of independence and death in the perioperative period. Data suggest that frailty is prevalent within the vascular surgical population, itself a high-risk group. As a result, identification of frail patients presenting for vascular surgery is of utmost importance. In this article, we discuss what is currently known about the burden of frailty in the vascular surgical population, how to identify those living with frailty preoperatively, the optimization of frailty, and their intraoperative and postoperative care.