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

Purpose: 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. Design: This feasibility study was implemented as a quality improvement initiative with a postimplementation group only. Methods: 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. Findings: 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. Conclusions: A detailed and comprehensive preoperative assessment remains the most efficient way to identify frail geriatric surgical patients.