Frailty and elderly in urology: implications for postoperative complications

Abstract

The demographic composition of the surgical population changes with the aging of the population. Older adults account for an increasing proportion of the surgical population, with > 35% of all inpatient operations being performed in adults aged 65 years or older in the United States. This proportion is higher in medicine subspecialties, such as urology, where 65% of all surgeries are performed in adults aged 65 years and older [1] and is anticipated to increase in the future. This situation is similar in every country including South Korea. Therefore, it is essential to understand the unique physiology and characteristics of older adults to provide optimal urologic care for these patients. The geriatric population is at a greater risk for postoperative complications than young adults. This risk is associated with the physiologic decline observed in this population known as frailty. Frailty is a state of decreased physiologic reserve that increases a patient's susceptibility to incapacity. Thus, by definition, frailty increases the risk of poor surgical outcomes. A few studies have reported outcomes, such as a higher risk of delirium, injury, intensive The geriatric population is at a greater risk of postoperative complications than young adults. This risk is associated with the physiologic decline seen in this population known as frailty. Unlike fitter patients, frail patients who undergo operative treatment have a greater likelihood of developing postoperative complications and endure prolonged hospital stays. This circumstance is comparable to the urological status. Therefore, tolerable measurement of frailty as a domain of pre-operative health status has been suggested to ascertain vulnerability in elderly patients. In this review, we will elaborate on the concept of frailty and examine its importance with respect to surgical complications, focusing on the urological status.