World Journal of Emergency Surgery (Jun 2023)
Assessing and managing frailty in emergency laparotomy: a WSES position paper
- Brian W. C. A. Tian,
- Philip F. Stahel,
- Edoardo Picetti,
- Giampiero Campanelli,
- Salomone Di Saverio,
- Ernest Moore,
- Denis Bensard,
- Boris Sakakushev,
- Joseph Galante,
- Gustavo P. Fraga,
- Kaoru Koike,
- Isidoro Di Carlo,
- Giovanni D. Tebala,
- Ari Leppaniemi,
- Edward Tan,
- Dimitris Damaskos,
- Nicola De’Angelis,
- Andreas Hecker,
- Michele Pisano,
- YunfengCui,
- Ron V. Maier,
- Belinda De Simone,
- Francesco Amico,
- Marco Ceresoli,
- Manos Pikoulis,
- Dieter G. Weber,
- Walt Biffl,
- Solomon Gurmu Beka,
- Fikri M. Abu-Zidan,
- Massimo Valentino,
- Federico Coccolini,
- Yoram Kluger,
- Massimo Sartelli,
- Vanni Agnoletti,
- Mircea Chirica,
- Francesca Bravi,
- Ibrahima Sall,
- Fausto Catena
Affiliations
- Brian W. C. A. Tian
- Department of General Surgery, Singapore General Hospital
- Philip F. Stahel
- Department of Orthopedic Surgery and Department of Neurosurgery, Denver Health Medical Center and University of Colorado School of Medicine
- Edoardo Picetti
- Department of Anesthesia and Intensive Care, Azienda Ospedaliero-Universitaria Parma
- Giampiero Campanelli
- John Hunter Hospital, University of Newcastle
- Salomone Di Saverio
- Unit of General Surgery, San Benedetto del Tronto Hospital
- Ernest Moore
- Department of Surgery, Denver Health Medical Center
- Denis Bensard
- Department of Surgery, Denver Health Medical Center
- Boris Sakakushev
- Research Institute of Medical University Plovdiv/University Hospital St George Plovdiv
- Joseph Galante
- Trauma Department, University of California
- Gustavo P. Fraga
- Faculdade de Ciências Médicas (FCM), Unicamp Campinas
- Kaoru Koike
- Department of Primary Care and Emergency Medicine, Kyoto University Graduate School of Medicine
- Isidoro Di Carlo
- Department of Surgical Sciences and Advanced Technologies “GF Ingrassia”, University of Catania, Cannizzaro Hospital
- Giovanni D. Tebala
- Oxford University Hospitals NHSFT John Radcliffe Hospital
- Ari Leppaniemi
- General Surgery Department, Helsinki University Hospital
- Edward Tan
- Department of Surgery, Radboud University Medical Center
- Dimitris Damaskos
- General and Emergency Surgery, Royal Infirmary of Edinburgh
- Nicola De’Angelis
- Hôpital Henri Mondor, Université Paris Est
- Andreas Hecker
- Department of General and Thoracic Surgery, University Hospital
- Michele Pisano
- General and Emergency Surgery, ASST Papa Giovanni XXIII
- YunfengCui
- Department of Surgery, Tianjin Nankai Hospital, Nankai Clinical School of Medicine, Tianjin Medical University
- Ron V. Maier
- Department of Surgery, Harborview Medical Centre, University of Washington
- Belinda De Simone
- Department of Emergency Surgery, Centre Hospitalier Intercommunal de Villeneuve-Saint-Georges
- Francesco Amico
- John Hunter Hospital, University of Newcastle
- Marco Ceresoli
- General Surgery, Monza University Hospital
- Manos Pikoulis
- 3Rd Department of Surgery, Attikon General Hospital, National and Kapodistrian University of Athens (NKUA)
- Dieter G. Weber
- Department of General Surgery, Royal Perth Hospital, University of Western Australia
- Walt Biffl
- Department of Trauma and Acute Care Surgery, Scripps Memorial Hospital La Jolla
- Solomon Gurmu Beka
- School of Medicine and Health Science, University of Otago
- Fikri M. Abu-Zidan
- The Research Office, College of Medicine and Health Sciences, United Arab Emirates University
- Massimo Valentino
- Department of Radiology, Tolmezzo Hospital
- Federico Coccolini
- General, Emergency and Trauma Surgery Department, Pisa University Hospital
- Yoram Kluger
- Division of General Surgery, Rambam Health Care Campus
- Massimo Sartelli
- Department of Surgery, Macerata Hospital
- Vanni Agnoletti
- Anesthesia and Intensive Care Unit, AUSL Romagna, M. Bufalini Hospital
- Mircea Chirica
- Service de Chirurgie Digestive, Centre Hospitalier Universitaire Grenoble Alpes
- Francesca Bravi
- Healthcare Administration, Santa Maria Delle Croci Hospital
- Ibrahima Sall
- Department of General Surgery, Military Teaching Hospital, Hôpital Principal Dakar
- Fausto Catena
- Department of Emergency and Trauma Surgery, Bufalini Hospital
- DOI
- https://doi.org/10.1186/s13017-023-00506-7
- Journal volume & issue
-
Vol. 18,
no. 1
pp. 1 – 16
Abstract
Abstract Many countries are facing an aging population. As people live longer, surgeons face the prospect of operating on increasingly older patients. Traditional teaching is that with older age, these patients face an increased risk of mortality and morbidity, even to a level deemed too prohibitive for surgery. However, this is not always true. An active 90-year-old patient can be much fitter than an overweight, sedentary 65-year-old patient with comorbidities. Recent literature shows that frailty—an age-related cumulative decline in multiple physiological systems, is therefore a better predictor of mortality and morbidity than chronological age alone. Despite recognition of frailty as an important tool in identifying vulnerable surgical patients, many surgeons still shun objective tools. The aim of this position paper was to perform a review of the existing literature and to provide recommendations on emergency laparotomy and in frail patients. This position paper was reviewed by an international expert panel composed of 37 experts who were asked to critically revise the manuscript and position statements. The position paper was conducted according to the WSES methodology. We shall present the derived statements upon which a consensus was reached, specifying the quality of the supporting evidence and suggesting future research directions.
Keywords
