title: Summary of the panel session at the 38th Annual Surgical Symposium of the Association of VA Surgeons: what is the big deal about frailty?
abstract: Owing to the phenomenon known as "global graying," elderly-specific conditions, including frailty, will become more prominent among patients undergoing surgery. The concept of frailty, its effect on surgical outcomes, and its assessment and management were discussed during the 38th Annual Surgical Symposium of the Association of VA Surgeons panel session entitled "What's the Big Deal about Frailty?" and held in New Haven, Connecticut, on April 7, 2014. The expert panel discussed the following questions and topics: (1) Why is frailty so important? (2) How do we identify the frail patient prior to the operating room? (3) The current state of the art: preoperative frail evaluation. (4) Preoperative interventions for frailty prior to operation: do they work? (5) Intraoperative management of the frail patient: does anesthesia play a role? (6) Postoperative care of the frail patient: is rescue the issue? This special communication summarizes the panel session topics and provides highlights of the expert panel's discussions and relevant key points regarding care for the geriatric frail surgical patient.
authors.affiliation: Houston VA Center for Innovations in Quality, Effectiveness and Safety (IQUEST), Michael E. DeBakey VA Medical Center, Houston, Texas2Operative Care Line, Michael E. DeBakey VA Medical Center, Houston, Texas3Michael E. DeBakey Department of Surgery, Baylo.
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Anaya
authors.affiliation: Operative Care Line, Nebraska-Western Iowa VA Medical Center, Omaha5Department of Surgery, University of Nebraska Medical Center, Omaha.
authors.forename: Jason
authors.initials: J
authors.lastname: Johanning
authors.affiliation: Operative Care Line, Miami VA Healthcare System, Miami, Florida.
authors.forename: Seth A
authors.initials: SA
authors.lastname: Spector
authors.affiliation: Sinai Center for Geriatric Surgery, Department of Surgery, Sinai Hospital, Baltimore, Maryland.
authors.forename: Mark R
authors.initials: MR
authors.lastname: Katlic
authors.affiliation: Department of Anesthesiology, VA Connecticut Healthcare System, New Haven9Yale University School of Medicine, New Haven, Connecticut.
authors.forename: Albert C
authors.initials: AC
authors.lastname: Perrino
authors.affiliation: Department of Anesthesiology, VA Connecticut Healthcare System, New Haven9Yale University School of Medicine, New Haven, Connecticut.
authors.forename: Jessica
authors.initials: J
authors.lastname: Feinleib
authors.affiliation: Surgical Service, VA Connecticut Healthcare System, New Haven11Department of Surgery, Yale University School of Medicine, New Haven, Connecticut.
authors.forename: Ronnie A
authors.initials: RA
authors.lastname: Rosenthal
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000758:Anesthesia / Q000009:adverse effects / Q000379:methods; D003693:Delirium / Q000139:chemically induced; D016330:Frail Elderly; D015577:Geriatric Assessment / Q000379:methods*; D006801:Humans; D059408:Pain Management / Q000379:methods; D018802:Patient-Centered Care / Q000379:methods*; D011182:Postoperative Care / Q000379:methods*; D011300:Preoperative Care / Q000379:methods*; D011788:Quality of Life; D016896:Treatment Outcome