1. Frailty
‘A distinctive health state related to the ageing process in which multiple body systems gradually lose their inbuilt reserves’
Fit for frailty, British Geriatric Society
Some people are old but not frail
Some people are frail but not old
Most frailty services start at 75 years

2. Audit of frailty assessment in colorectal patients at uhb
Sarah Biggs, CT1
Rory Spanton, ERAS Lead Nurse
Jonathan Randall, Consultant Surgeon

3. Method Retrospective data collection
12 months of elective colorectal operations (ERAS)
Frailty scores from POAC- ACS/NSQIP Frailty score. ‘Not Frail, Intermediate, Frail.
Outcomes from ERAS data

4. Results 246 patient over 12 months 73/246 patients >70 = 29%
Of the 73 patients >70 only 48 had frailty score done = 66%
Frailty score
Number 39 1 5 2 3

5. Frailty score and LOS Frailty score No. Patients
Average of Length of stay (days)
Anterior resection 1 12
Lap anterior resection 4 21
Lap AP resection 5
Lap Hartmann's 7
Lap right hemi 16 6
Right hemi
10.5
TEMS 2
1.5
Frailty score
No. Patients
Average of Length of stay (days) 2
Lap right hemi 14
TEMS 1 27
Frailty score
No. Patients
Average of Length of stay (days) 3 66
Lap anterior resection 1
Frailty score
No. patients
Average of Length of stay (days) 1
6.2
Anterior resection 6
AP resection
Lap right hemi 2
Reversal colostomy 7

7. Improvements
Assessment Tool
Timing of Assessment
Intervention

8. Rockwood cfs

9. Timing of assessment and directing
Fast track clinic
Results clinic
Specific POAC pathway?
Mobility Comorbidities
Nutrition Polypharmacy
Cognition Social Care Needs
Mood
COMPREHENSIVE GERIARIC ASSESSMENT

10. Interventions at UH Bristol
Prehabilitation Support Programme
Pilot of Macmillan AHP Cancer Rehabilitation Project
Exercise Plan with individual goals. Pre- and post-operative follow up calls
Will feedback results to SWAG and CCG
Aim of establishing a tariff for prehab within patient pathway
Also School of Surgery.
Directly employing prehab practitioner

11. HOW DO OTHERS DO IT? NORTH BRISTOL
Geriatrician offers CGA pre-operatively
ROYAL UNITED HOSPITALS BATH
Combined surgical/anaesthetic frailty project.
Starting in 2ww clinic. Though MDT into POAC with physio input.