Frailty and its implication for Anaesthesiologists.

Frailty as a concept emerged as a geriatric term more than three decades ago, but although the concept was easy to understand its practical translation to individual patient care and the availability of robust methods to identify frail patients remained a problem for a long time . It was only in the past 20 years that two important “schools” of frailty developed, one based on the “accumulated deficit” model and the other based on “phenotype” criteria where the latter operationalized frailty to five characteristics: shrinking (weight loss and sarcopenia), weakness, poor endurance, slowness and low physical activity. The latter then defined frail patients as those having ≥ 3 positive criteria, and those with one or two of these characteristics as prefrail. The concept of frailty gradually spread outside the realm of geriatrics and reached our specialty with a review paper in 2011 concerning the critical ill. Here the Clinical Frailty Scale (CFS) probably was introduced for the first time to this audience. Ten years later there are now multiple papers published on frailty, many with relevance for intensivists, emergency physicians and anaesthesiologists, also printed in this journal .