title: Screening for Frailty in Thoracic Surgical Patients.
abstract: BACKGROUND
  The presence of frailty or prefrailty in older adults is a risk factor for postsurgical complications. The frailty phenotype can be improved through long-term resistance and aerobic training. It is unknown whether short-term preoperative interventions targeting frailty will help to mitigate surgical risk. The purpose of this study was to determine the proportion of frail and prefrail patients presenting to a thoracic surgical clinic who could benefit from a frailty reduction intervention.
  
  
  METHODS
  A prospective cohort study was performed at a single-site thoracic surgical clinic. Starting October 1, 2014, surgical candidates 60 years of age or older who consented to be screened were included. Patients were screened using an adapted version of Fried's phenotypic frailty criteria: weakness (grip strength), slow gait (15-foot walk), unintentional weight loss, self-reported exhaustion, and low self-reported physical activity (Physical Activity Scale for the Elderly). Prefrailty was identified when participants demonstrated one to two frailty characteristics; frailty was identified when participants demonstrated three to five frailty characteristics.
  
  
  RESULTS
  Of 180 eligible patients, 126 consented, and 125 completed screening. Thirty-nine participants (31%) were not frail, 71 (57%) were prefrail, and 15 (12%) were frail. Exhaustion was the most common frailty symptom (34%). Frailty prevalence did not significantly differ among men and women (men: 10%, women: 14%; p = 0.75).
  
  
  CONCLUSIONS
  We found a high proportion of prefrail and frail patients among patients deemed candidates for thoracic surgical procedures. This finding indicates that frailty may be underrecognized. Substantial numbers of patients may be considered for a presurgical frailty reduction intervention.
authors.affiliation: Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin. Electronic address: abeckert@mcw.edu.
authors.forename: Angela K
authors.initials: AK
authors.lastname: Beckert
authors.affiliation: Department of Medicine, The University of Chicago Medicine, Chicago, Illinois.
authors.forename: Megan
authors.initials: M
authors.lastname: Huisingh-Scheetz
authors.affiliation: Department of Medicine, The University of Chicago Medicine, Chicago, Illinois.
authors.forename: Katherine
authors.initials: K
authors.lastname: Thompson
authors.affiliation: Department of Surgery, The University of Chicago Medicine, Chicago, Illinois.
authors.forename: Amy D
authors.initials: AD
authors.lastname: Celauro
authors.affiliation: Department of Surgery, The University of Chicago Medicine, Chicago, Illinois.
authors.forename: Jordan
authors.initials: J
authors.lastname: Williams
authors.affiliation: Department of Surgery, The University of Chicago Medicine, Chicago, Illinois.
authors.forename: Paul
authors.initials: P
authors.lastname: Pachwicewicz
authors.affiliation: Department of Surgery, The University of Chicago Medicine, Chicago, Illinois; Comprehensive Cancer Center, The University of Chicago Medicine, Chicago, Illinois.
authors.forename: Mark K
authors.initials: MK
authors.lastname: Ferguson
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015444:Exercise; D005221:Fatigue; D005260:Female; D016330:Frail Elderly; D005684:Gait; D015577:Geriatric Assessment; D018737:Hand Strength; D006801:Humans; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D057566:Self Report; D019616:Thoracic Surgical Procedures; D015431:Weight Loss