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Purpose of Review <p>As the population ages, older patients are increasingly seeking neurosurgical care. Effective perioperative risk stratification is necessary to determine which older adults may benefit from neurosurgery. Frailty is a major risk factor for postoperative morbidity and mortality, but its role in neurosurgery is less understood. In this review, we summarize the latest evidence on frailty in neurosurgery.</p> Recent Findings <p>We discuss an evidence-based approach to frailty assessment, the impact of frailty on outcomes in cranial and spinal pathologies, and perioperative management strategies for older neurosurgical patients. Frailty predicts unfavourable outcomes after neurosurgery and should be assessed in conjunction with chronological age for perioperative risk stratification. Current evidence is mostly limited to frailty proxy tools rather than true multidimensional instruments.</p> Summary <p>Further prospective research is needed to evaluate the role of multidimensional frailty assessment and identify modifiable risk factors to improve outcomes among older neurosurgical patients.</p>

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Frailty and the Older Neurosurgical Patient: Assessment, Outcomes and Management

  • 期刊论文

  • 发表日期：

    2025年1月27日

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  • Adele S. Budiansky,
  • Dan Budiansky,
  • Daniel I. McIsaac

摘要

Purpose of Review

As the population ages, older patients are increasingly seeking neurosurgical care. Effective perioperative risk stratification is necessary to determine which older adults may benefit from neurosurgery. Frailty is a major risk factor for postoperative morbidity and mortality, but its role in neurosurgery is less understood. In this review, we summarize the latest evidence on frailty in neurosurgery.

Recent Findings

We discuss an evidence-based approach to frailty assessment, the impact of frailty on outcomes in cranial and spinal pathologies, and perioperative management strategies for older neurosurgical patients. Frailty predicts unfavourable outcomes after neurosurgery and should be assessed in conjunction with chronological age for perioperative risk stratification. Current evidence is mostly limited to frailty proxy tools rather than true multidimensional instruments.

Summary

Further prospective research is needed to evaluate the role of multidimensional frailty assessment and identify modifiable risk factors to improve outcomes among older neurosurgical patients.