Subjective assessment
As part of the routine evaluation of patients prior to surgery, patients
were clinically assessed by two experienced clinicians (RGD and IRA) to
determine frailty and fitness for surgery. The clinical evaluation
included the detailed collection of a patient-specific medical history.
This clinical determination aimed to answer the question “Is this
patient attending for clinical assessment today fit enough for the
proposed surgical procedure?” Each patient was judged to be either
‘frail’ or ‘not frail’ after the initial meeting, and this was
supplemented with “fit” or “not fit” from careful review of their
medical notes. Patients were also graded according to the American
Society of Anaesthesiologists (ASA) grading criteria11whereby a healthy patient is ASA I, a patient with mild systemic disease
is ASA II, a patient with severe systemic disease is ASA III, ASA IV
refers to a patient with life‐threatening severe systemic disease and
ASA V to a moribund patient.