Abstract
Introduction
Frailty is associated with an increased risk of perioperative complications, prolonged hospital stay, and functional decline after surgery. Despite the potential advantages of early detection, frailty screening of surgical patients is not standard practice across the UK. Digital questionnaires may offer an effective tool for screening large patient populations; however, there is concern that this is biased when used in frail or elderly patients. The primary aim of this study was to evaluate the effectiveness of digital screening in patients aged 65 and over who are awaiting elective general surgery.
Method
We distributed digital questionnaires to 738 patients via text message. Participants were eligible if aged 65 or older and on the waiting list for elective general surgery. Participants had a 7-day period to complete the questionnaire, with a reminder sent 5 weeks later to non-responders. Participants self-assessed frailty using a modified Clinical Frailty Scale (CFS), those who scored above 3 were also asked to complete the Comprehensive Risk Assessment and Needs Evaluation and EQ-5D-3L questionnaire. We analysed response rate, frailty and age. Results 187 (25.34%) patients responded within the initial period. A further 156 (21.14%) responded following the reminder. The overall response rate was 46.48%. The average age of responders was 72. Our data showed that frailer patients were able to complete digital questionnaires either themselves or with support.
Conclusion
Early screening can help identify frail patients who would benefit from peri-operative planning and optimisation, including a geriatric review. Our findings suggest that digital questionnaires could be an effective tool for screening older adults and that frail patients are able to participate. This may be due to various factors, including caregivers support. Previous studies have documented response rates ranging from 30% to 50%, which provides a valuable benchmark for the interpretation of our findings.