<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1688-0390</journal-id>
<journal-title><![CDATA[Revista Médica del Uruguay]]></journal-title>
<abbrev-journal-title><![CDATA[Rev. Méd. Urug.]]></abbrev-journal-title>
<issn>1688-0390</issn>
<publisher>
<publisher-name><![CDATA[Sindicato Médico del Uruguay]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1688-03902023000101205</article-id>
<article-id pub-id-type="doi">10.29193/rmu.39.1.6</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Prevalencia de fragilidad en cirugía electiva para personas mayores usuarios del Hospital de Clínicas. Análisis de la población quirúrgica de personas mayores del Hospital de Clínicas &#8220;Dr. Manuel Quintela&#8221; (marzo 2019-marzo 2020)]]></article-title>
<article-title xml:lang="en"><![CDATA[Prevalence of frailty in elective surgery for older adults at Clínicas Hospital. Analysis of the surgical population of older adults at &#8220;Dr. Manuel Quintela&#8221; University Hospital from March, 2029 to March, 2020]]></article-title>
<article-title xml:lang="pt"><![CDATA[Prevalência de fragilidade em cirurgia eletiva em idosos usuários do Hospital de Clínicas. Análise da população cirúrgica de idosos do Hospital de Clínicas &#8220;Dr. Manuel Quintela&#8221; (março 2019-março 2020)]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[García]]></surname>
<given-names><![CDATA[Renzo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Noya]]></surname>
<given-names><![CDATA[Beatriz]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Surbano]]></surname>
<given-names><![CDATA[Marta]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Cavallieri]]></surname>
<given-names><![CDATA[Fiorella]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Bouchacourt]]></surname>
<given-names><![CDATA[Juan Pablo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Illescas]]></surname>
<given-names><![CDATA[Laura]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[González]]></surname>
<given-names><![CDATA[Leandro]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Lladó]]></surname>
<given-names><![CDATA[Natalia]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Kmaid]]></surname>
<given-names><![CDATA[Ana]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Riva]]></surname>
<given-names><![CDATA[Juan]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,UDELAR Facultad de Medicina Hospital de Clínicas]]></institution>
<addr-line><![CDATA[Montevideo ]]></addr-line>
<country>Uruguay</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,UDELAR Facultad de Medicina Hospital de Clínicas]]></institution>
<addr-line><![CDATA[Montevideo ]]></addr-line>
<country>Uruguay</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,UDELAR Facultad de Medicina Hospital de Clínicas]]></institution>
<addr-line><![CDATA[Montevideo ]]></addr-line>
<country>Uruguay</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,UDELAR Facultad de Medicina Hospital de Clínicas]]></institution>
<addr-line><![CDATA[Montevideo ]]></addr-line>
<country>Uruguay</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,UDELAR Facultad de Medicina Hospital de Clínicas]]></institution>
<addr-line><![CDATA[Montevideo ]]></addr-line>
<country>Uruguay</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,UDELAR Facultad de Medicina Hospital de Clínicas]]></institution>
<addr-line><![CDATA[Montevideo ]]></addr-line>
<country>Uruguay</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,UDELAR Facultad de Medicina Hospital de Clínicas]]></institution>
<addr-line><![CDATA[Montevideo ]]></addr-line>
<country>Uruguay</country>
</aff>
<aff id="Af5">
<institution><![CDATA[,UDELAR Facultad de Medicina Hospital de Clínicas]]></institution>
<addr-line><![CDATA[Montevideo ]]></addr-line>
<country>Uruguay</country>
</aff>
<aff id="Af6">
<institution><![CDATA[,UDELAR Facultad de Medicina Hospital de Clínicas]]></institution>
<addr-line><![CDATA[Montevideo ]]></addr-line>
<country>Uruguay</country>
</aff>
<aff id="Af7">
<institution><![CDATA[,UDELAR Facultad de Medicina Hospital de Clínicas]]></institution>
<addr-line><![CDATA[Montevideo ]]></addr-line>
<country>Uruguay</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>00</month>
<year>2023</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>00</month>
<year>2023</year>
</pub-date>
<volume>39</volume>
<numero>1</numero>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.edu.uy/scielo.php?script=sci_arttext&amp;pid=S1688-03902023000101205&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.edu.uy/scielo.php?script=sci_abstract&amp;pid=S1688-03902023000101205&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.edu.uy/scielo.php?script=sci_pdf&amp;pid=S1688-03902023000101205&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen: La fragilidad determina una incapacidad para enfrentar estresores debido a la disminución de las reservas fisiológicas multisistémicas. El acto anestésico quirúrgico constituye un evento estresante y la presencia de fragilidad es un factor de riesgo independiente de morbimortalidad perioperatoria. Identificarla permitiría abordar los factores reversibles que la determinan con la intención de disminuir los riesgos inherentes a dicho acto. Su detección en la valoración perioperatoria aporta información relevante que no se obtiene con una evaluación tradicional. Este enfoque se ha convertido en un estándar en la valoración perioperatoria de personas mayores. El objetivo del estudio es valorar la prevalencia de fragilidad en la cirugía electiva de personas mayores en el Hospital de Clínicas. Es un estudio prospectivo y descriptivo. Fue aprobado por el Comité de Ética institucional. Se reclutaron 206 pacientes de 65 años y más, coordinados para cirugía electiva, entre marzo del 2019 y marzo del 2020. Se aplicó la Escala de Fragilidad de Edmonton Reportada (REFS) para la detección de la fragilidad. La prevalencia de fragilidad fue del 22,8% con un IC 16-29,6, por lo que decimos que es alta en esta población y similar al de otros contextos quirúrgicos y no quirúrgicos. Se encontraron un número significativamente mayor de hipertensión arterial, arritmias, diabetes, hipotiroidismo y tabaquismo entre los pacientes frágiles. Su prevalencia e impacto en la morbimortalidad operatoria constituyen razones de peso para su inclusión en la valoración perioperatoria en nuestro sistema de salud así como la capacitación de los anestesiólogos en la detección de la fragilidad a través del uso de herramientas prácticas, válidas y confiables.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract: Frailty determines an inability to cope with stressors due to decreased multisystem physiologic reserves. The surgical anesthetic act is a stressful event and the presence of frailty is an independent risk factor for perioperative morbidity and mortality Detection of frailty would allow for addressing reversible factors causing it, with the intention of reducing the risks that are inherent to anesthetic acts. Detection in the perioperative assessment provides relevant information that is not obtained in a traditional evaluation. This approach has become the standard in perioperative assessment of geriatric surgical patients. The study aims to assess the prevalence of frailty in elective surgery for the elderly at Clínicas Hospital.  Method:  prospective, descriptive study approved by the institutional Ethics Committee. 206 patients aged 65 years old and over who had been coordinated for elective surgery were recruited for the study between March, 2019 and March, 2020. The Reported Edmonton Frailty Scale (REFS) was applied to detect frailty. Prevalence of frailty was 22.8% with a CI of 16-29 in this population, rather high and similar to the frail patients percentages in other surgical and non-surgical settings. Significantly higher numbers of arterial hypertension, arrhythmias, diabetes and hypothyroidism cases and tobacco users were found among frail patients. Prevalence and impact of frailty on operative morbidity and mortality are compelling reasons for its inclusion in the perioperative assessment of our health system, as well as the training of anesthesiologists in the detection of frailty through the use of practical, valid and reliable tools.]]></p></abstract>
<abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo: A fragilidade determina uma incapacidade de lidar com estressores devido à diminuição das reservas fisiológicas multissistêmicas. O ato anestésico cirúrgico é um evento estressante e a presença de fragilidade é um fator de risco independente para morbimortalidade perioperatória. Identificá-lo permitiria abordar os fatores reversíveis que o determinam com o intuito de reduzir os riscos inerentes ao referido ato. Sua detecção na avaliação perioperatória fornece informações relevantes que não são obtidas com uma avaliação tradicional. Essa abordagem tornou-se padrão na avaliação perioperatória de idosos. O objetivo do estudo é avaliar a prevalência de fragilidade em cirurgias eletivas para idosos no Hospital de Clínicas. Realizou-se um estudo prospectivo e descritivo, aprovado pelo Comitê de Ética institucional. 206 pacientes com 65 anos ou mais, coordenados para cirurgia eletiva, foram recrutados entre março de 2019 e março de 2020. A Reported Edmonton Frailty Scale (REFS) foi aplicada para detectar fragilidade. A prevalência de fragilidade foi de 22,8% com um IC de 16-29,6, pelo que podemos dizer que é elevada nesta população e semelhante à de outros contextos cirúrgicos e não cirúrgicos. Números significativamente maiores de hipertensão arterial, arritmias, diabetes, hipotireoidismo e tabagismo foram encontrados entre os pacientes frágeis. A prevalência e impacto da fragilidade na morbimortalidade operatória são razões convincentes para sua inclusão na avaliação perioperatória em nosso sistema de saúde, bem como para o treinamento de anestesistas na detecção de fragilidade por meio do uso de ferramentas práticas, válidas e confiáveis.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Fragilidad]]></kwd>
<kwd lng="es"><![CDATA[Valoración de riesgo]]></kwd>
<kwd lng="es"><![CDATA[Cirugía]]></kwd>
<kwd lng="es"><![CDATA[Escores de Fragilidad]]></kwd>
<kwd lng="es"><![CDATA[Anciano]]></kwd>
<kwd lng="es"><![CDATA[Prevalencia]]></kwd>
<kwd lng="en"><![CDATA[Frailty]]></kwd>
<kwd lng="en"><![CDATA[Risk assessment]]></kwd>
<kwd lng="en"><![CDATA[Surgery]]></kwd>
<kwd lng="en"><![CDATA[Aged]]></kwd>
<kwd lng="en"><![CDATA[Frailty scores]]></kwd>
<kwd lng="en"><![CDATA[Prevalence]]></kwd>
<kwd lng="pt"><![CDATA[Fragilidade]]></kwd>
<kwd lng="pt"><![CDATA[Avaliação de risco]]></kwd>
<kwd lng="pt"><![CDATA[Cirurgia]]></kwd>
<kwd lng="pt"><![CDATA[Pontuações de fragilidade]]></kwd>
<kwd lng="pt"><![CDATA[Idoso]]></kwd>
<kwd lng="pt"><![CDATA[Prevalencia]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Savio]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
<name>
<surname><![CDATA[Talice]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Vodanovich]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
</person-group>
<source><![CDATA[Guía de fragilidad en personas adultas mayores: criterios prácticos e instrumentos de pesquisa en el primer nivel de atención]]></source>
<year>2022</year>
<publisher-loc><![CDATA[Montevideo ]]></publisher-loc>
<publisher-name><![CDATA[MSP]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Savio]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[La atención de la fragilidad en el adulto mayor]]></article-title>
<source><![CDATA[Tendencias]]></source>
<year>2021</year>
<volume>58</volume>
<page-range>127-36</page-range></nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Fried]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Tangen]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Walston]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Newman]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Hirsch]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Gottdiener]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Frailty in older adults evidence for a phenotype]]></article-title>
<source><![CDATA[J Gerontol A Biol Sci Med Sci]]></source>
<year>2001</year>
<volume>56</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>M146-56</page-range></nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Etzioni]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Liu]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Maggard]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Ko]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The aging population and its impact on the surgery workforce]]></article-title>
<source><![CDATA[Ann Surg]]></source>
<year>2003</year>
<volume>238</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>170-7</page-range></nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Speziale]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Nasso]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Barattoni]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Bonifazi]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Esposito]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Coppola]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Operative and middle-term results of cardiac surgery in nonagenarians a bridge toward routine practice]]></article-title>
<source><![CDATA[Circulation]]></source>
<year>2010</year>
<volume>121</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>208-13</page-range></nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Rockwood]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Mitnitski]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Frailty in relation to the accumulation of deficits]]></article-title>
<source><![CDATA[J Gerontol A Biol Sci Med Sci]]></source>
<year>2007</year>
<volume>62</volume>
<numero>7</numero>
<issue>7</issue>
<page-range>722-7</page-range></nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Amblàs Novellas]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Martori]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Molist Brunet]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Oller]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Gómez Batiste]]></surname>
<given-names><![CDATA[X]]></given-names>
</name>
<name>
<surname><![CDATA[Espaulella Panicot]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Índice frágil-VIG diseño y evaluación de un índice de fragilidad basado en la valoración integral geriátrica]]></article-title>
<source><![CDATA[Rev Esp Geriatr Gerontol]]></source>
<year>2017</year>
<volume>52</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>119-27</page-range></nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Faller]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Pereira]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[de Souza]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Nampo]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Orlandi]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Matumoto]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Instruments for the detection of frailty syndrome in older adults a systematic review]]></article-title>
<source><![CDATA[PLoS One]]></source>
<year>2019</year>
<volume>14</volume>
<numero>4</numero>
<issue>4</issue>
</nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Dent]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Kowal]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Hoogendijk]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Frailty measurement in research and clinical practice a review]]></article-title>
<source><![CDATA[Eur J Intern Med]]></source>
<year>2016</year>
<volume>31</volume>
<page-range>3-10</page-range></nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Milder]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Pillinger]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Kam]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The role of prehabilitation in frail surgical patients A systematic review]]></article-title>
<source><![CDATA[Acta Anaesthesiol Scand]]></source>
<year>2018</year>
<volume>62</volume>
<numero>10</numero>
<issue>10</issue>
<page-range>1356-66</page-range></nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Colburn]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Mohanty]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Burton]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Surgical guidelines for perioperative management of older adults what geriatricians need to know]]></article-title>
<source><![CDATA[J Am Geriatr Soc]]></source>
<year>2017</year>
<volume>65</volume>
<numero>6</numero>
<issue>6</issue>
<page-range>1339-46</page-range></nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[McIsaac]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[MacDonald]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Aucoin]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Frailty for perioperative clinicians a narrative review]]></article-title>
<source><![CDATA[Anesth Analg]]></source>
<year>2020</year>
<volume>130</volume>
<numero>6</numero>
<issue>6</issue>
<page-range>1450-60</page-range></nlm-citation>
</ref>
<ref id="B13">
<label>13</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Collard]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Boter]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Schoevers]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Oude Voshaar]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Prevalence of frailty in community-dwelling older persons a systematic review]]></article-title>
<source><![CDATA[J Am Geriatr Soc]]></source>
<year>2012</year>
<volume>60</volume>
<numero>8</numero>
<issue>8</issue>
<page-range>1487-92</page-range></nlm-citation>
</ref>
<ref id="B14">
<label>14</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Banning]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[El Moumni]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Visser]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[van Leeuwen]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Zeebregts]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Pol]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Frailty leads to poor long-term survival in patients undergoing elective vascular surgery]]></article-title>
<source><![CDATA[J Vasc Surg]]></source>
<year>2021</year>
<volume>73</volume>
<numero>6</numero>
<issue>6</issue>
<page-range>2132-9</page-range></nlm-citation>
</ref>
<ref id="B15">
<label>15</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Makary]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Segev]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Pronovost]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Syin]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Bandeen-Roche]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Patel]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Frailty as a predictor of surgical outcomes in older patients]]></article-title>
<source><![CDATA[J Am Coll Surg]]></source>
<year>2010</year>
<volume>210</volume>
<numero>6</numero>
<issue>6</issue>
<page-range>901-8</page-range></nlm-citation>
</ref>
<ref id="B16">
<label>16</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Wagner]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[DeMarco]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Amini]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Buttner]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Segev]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Gani]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Role of frailty and sarcopenia in predicting outcomes among patients undergoing gastrointestinal surgery]]></article-title>
<source><![CDATA[World J Gastrointest Surg]]></source>
<year>2016</year>
<volume>8</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>27-40</page-range></nlm-citation>
</ref>
<ref id="B17">
<label>17</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Rolfson]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Majumdar]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Tsuyuki]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Tahir]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Rockwood]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Validity and reliability of the Edmonton Frail Scale]]></article-title>
<source><![CDATA[Age Ageing]]></source>
<year>2006</year>
<volume>35</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>526-9</page-range></nlm-citation>
</ref>
<ref id="B18">
<label>18</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Hilmer]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Perera]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
<name>
<surname><![CDATA[Mitchell]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Murnion]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Dent]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Bajorek]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The assessment of frailty in older people in acute care]]></article-title>
<source><![CDATA[Australas J Ageing]]></source>
<year>2009</year>
<volume>28</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>182-8</page-range></nlm-citation>
</ref>
<ref id="B19">
<label>19</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Bernabeu-Mora]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[García-Guillamón]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Valera-Novella]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Giménez-Giménez]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Escolar-Reina]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Medina-Mirapeix]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Frailty is a predictive factor of readmission within 90 days of hospitalization for acute exacerbations of chronic obstructive pulmonary disease a longitudinal study]]></article-title>
<source><![CDATA[Ther Adv Respir Dis]]></source>
<year>2017</year>
<volume>11</volume>
<numero>10</numero>
<issue>10</issue>
<page-range>383-92</page-range></nlm-citation>
</ref>
<ref id="B20">
<label>20</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Vargas]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Gálvez]]></surname>
<given-names><![CDATA[MA]]></given-names>
</name>
<name>
<surname><![CDATA[Rojas]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Honorato]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Andrade]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Leyton]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Fragilidad en busca de herramientas de evaluación preoperatoria]]></article-title>
<source><![CDATA[Rev Méd Chile]]></source>
<year>2020</year>
<volume>148</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>311-9</page-range></nlm-citation>
</ref>
<ref id="B21">
<label>21</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Maxwell]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Patel]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Suarez-Rodriguez]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Miller]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Frailty and prognostication in geriatric surgery and trauma]]></article-title>
<source><![CDATA[Clin Geriatr Med]]></source>
<year>2019</year>
<volume>35</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>13-26</page-range></nlm-citation>
</ref>
<ref id="B22">
<label>22</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Bautista]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[DiDonato]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Bennett]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Bautista]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The Edmonton Frail Scale as a preoperative assessment tool in elective outpatient surgery]]></article-title>
<source><![CDATA[Can J Anaesth]]></source>
<year>2021</year>
<volume>68</volume>
<numero>6</numero>
<issue>6</issue>
<page-range>925-7</page-range></nlm-citation>
</ref>
<ref id="B23">
<label>23</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Dhesi]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Lees]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Partridge]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Frailty in the perioperative setting]]></article-title>
<source><![CDATA[Clin Med (Lond)]]></source>
<year>2019</year>
<volume>19</volume>
<numero>6</numero>
<issue>6</issue>
<page-range>485-9</page-range></nlm-citation>
</ref>
<ref id="B24">
<label>24</label><nlm-citation citation-type="journal">
<collab>O'Caoimh R.Sezgin D.O'Donovan M.Molloy D.Clegg A.Rockwood K</collab>
<article-title xml:lang=""><![CDATA[Prevalence of frailty in 62 countries across the world a systematic review and meta-analysis of population-level studies]]></article-title>
<source><![CDATA[Age Ageing]]></source>
<year>2021</year>
<volume>50</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>96-104</page-range></nlm-citation>
</ref>
<ref id="B25">
<label>25</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Ramírez Ramírez]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Cadena Sanabria]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Ochoa]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Aplicación de la Escala de fragilidad de Edmonton en población colombiana Comparación con los criterios de Fried]]></article-title>
<source><![CDATA[Rev Esp Geriatr Gerontol]]></source>
<year>2017</year>
<volume>52</volume>
<numero>6</numero>
<issue>6</issue>
<page-range>322-5</page-range></nlm-citation>
</ref>
<ref id="B26">
<label>26</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Cooper]]></surname>
<given-names><![CDATA[Z]]></given-names>
</name>
<name>
<surname><![CDATA[Rogers Jr]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Ngo]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Guess]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Schmitt]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Jones]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Comparison of frailty measures as predictors of outcomes after orthopedic surgery]]></article-title>
<source><![CDATA[J Am Geriatr Soc]]></source>
<year>2016</year>
<volume>64</volume>
<numero>12</numero>
<issue>12</issue>
<page-range>2464-71</page-range></nlm-citation>
</ref>
<ref id="B27">
<label>27</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Robinson]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Wu]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Pointer]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Dunn]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Cleveland Jr]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Moss]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Simple frailty score predicts postoperative complications across surgical specialties]]></article-title>
<source><![CDATA[Am J Surg]]></source>
<year>2013</year>
<volume>206</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>544-50</page-range></nlm-citation>
</ref>
<ref id="B28">
<label>28</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Lin]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Watts]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Peel]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Hubbard]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Frailty and post-operative outcomes in older surgical patients a systematic review]]></article-title>
<source><![CDATA[BMC Geriatr]]></source>
<year>2016</year>
<volume>16</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>157</page-range></nlm-citation>
</ref>
<ref id="B29">
<label>29</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Bissot]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Henin]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Aunac]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Colinet]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Barvais]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Simonet]]></surname>
<given-names><![CDATA[O]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Preoperative frailty assessment a review]]></article-title>
<source><![CDATA[Acta Anaesthesiol Belg]]></source>
<year>2016</year>
<volume>67</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>157-73</page-range></nlm-citation>
</ref>
<ref id="B30">
<label>30</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Chow]]></surname>
<given-names><![CDATA[W]]></given-names>
</name>
<name>
<surname><![CDATA[Rosenthal]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Merkow]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Ko]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Esnaola]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Optimal preoperative assessment of the geriatric surgical patient a best practices guideline from the American College of Surgeons National Surgical Quality Improvement Program and the American Geriatrics Society]]></article-title>
<source><![CDATA[J Am Coll Surg]]></source>
<year>2012</year>
<volume>215</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>453-66</page-range></nlm-citation>
</ref>
<ref id="B31">
<label>31</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Murthy]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Hepner]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Cooper]]></surname>
<given-names><![CDATA[Z]]></given-names>
</name>
<name>
<surname><![CDATA[Bader]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Neuman]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Controversies in anaesthesia for noncardiac surgery in older adults]]></article-title>
<source><![CDATA[Br J Anaesth]]></source>
<year>2015</year>
<volume>115</volume>
<numero>Suppl 2</numero>
<issue>Suppl 2</issue>
<page-range>ii15-25</page-range></nlm-citation>
</ref>
<ref id="B32">
<label>32</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Aucoin]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Hao]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Sohi]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Shaw]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Bentov]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
<name>
<surname><![CDATA[Walker]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Accuracy and feasibility of clinically applied frailty instruments before surgery a systematic review and meta-analysis]]></article-title>
<source><![CDATA[Anesthesiology]]></source>
<year>2020</year>
<volume>133</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>78-95</page-range></nlm-citation>
</ref>
<ref id="B33">
<label>33</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Fernandes]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Gomes]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Guerra]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Pirkle]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Vafaei]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Curcio]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Frailty syndrome and risk of cardiovascular disease analysis from the International Mobility in Aging Study]]></article-title>
<source><![CDATA[Arch Gerontol Geriatr]]></source>
<year>2021</year>
<volume>92</volume>
<page-range>104279</page-range></nlm-citation>
</ref>
<ref id="B34">
<label>34</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Newman]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Gottdiener]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Mcburnie]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Hirsch]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Kop]]></surname>
<given-names><![CDATA[W]]></given-names>
</name>
<name>
<surname><![CDATA[Tracy]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Associations of subclinical cardiovascular disease with frailty]]></article-title>
<source><![CDATA[J Gerontol A Biol Sci Med Sci]]></source>
<year>2001</year>
<volume>56</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>M158-66</page-range></nlm-citation>
</ref>
<ref id="B35">
<label>35</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Stewart]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Cardiovascular disease and frailty what are the mechanistic links?]]></article-title>
<source><![CDATA[Clin Chem]]></source>
<year>2019</year>
<volume>65</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>80-6</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
