Implementation of Vulnerable Elders Survey-13 Frailty Tool to Identify At-Risk Geriatric Surgical Patients

Abstract

The primary purpose of this project was to preoperatively identify frail and vulnerable geriatric patients aged 65 or older using the Vulnerable Elders Survey (VES-13) tool, and to use those scores to assist with perioperative decision-making. This feasibility study was implemented as a quality improvement initiative with a postimplementation group only. The VES-13 was introduced to the perioperative nursing staff and anesthesia providers and then added to the traditional preoperative assessment. The VES-13 scores were correlated to hospital length of stay, postanesthesia care unit stay, altered mental status, and morbidity. Increased identification of older adult surgical patients at risk for increased length of stay, altered mental status, and morbidity in the preoperative setting was not evident, although the VES-13 was effective in identifying functional deficits in the older adult surgical patient. A detailed and comprehensive preoperative assessment remains the most efficient way to identify frail geriatric surgical patients.