The place of frailty and vulnerability in the surgical risk assessment: should we move from complexity to simplicity?

Due to aging of the world population, older patients accessing health services are becoming continuously more frequent. This has increased the interest in assessing frailty and vulnerability in all specialties and general medicine. Although the term frailty has been recognized for over 30 years, there is not yet a universally recognized definition, and different care providers assess frailty and vulnerability with dissimilar tools, from very complex to very simple validated scales. Being treated with respect and dignity at the right time and place is the key message, as well as after undergoing a global evaluation both in urgency/emergency and in programmed surgery for all older surgical patients. Filling the gap will improve the results of any clinical intervention, both medical and surgical. Anesthesiologists, surgeons, hospitalists, and any member of the team of care providers must be trained into geriatric syndromes.