"Media Advisory To contact Daniel E. Hall M.D. M.Div. M.H.Sc. email Sheila Tunney at sheila.tunneyva.gov mailtosheila.tunneyva.gov. Related material Also available at the For the Media website httpmedia.jamanetwork.com the commentary A Call for Frailty Screening in the Preoperative Setting by Anne M. Suskind M.D. M.S. and Emily Finlayson M.D. M.S. of the University of California San Francisco. To place an electronic embedded link to this study in your story This link will be live at the embargo time httpjamanetwork.comjournalsjamasurgeryfullarticle.jamasurg..   JAMA Surgery In a study published online by JAMA Surgery Daniel E. Hall M.D. M.Div. M.H.Sc. of the Veterans Affairs Pittsburgh Healthcare System and University of Pittsburgh and colleagues examined the effect of a Frailty Screening Initiative FSI on death and complications by comparing the surgical outcomes of patients treated before and after implementation of the FSI. As the U.S. population ages the number of operations performed on elderly patients will likely increase. Frailty predicts postoperative mortality and illness more than age alone thus presenting opportunities to identify the highestrisk surgical patients and provide tailored clinical care to improve their outcomes. This study included  patients average age  years from a Veterans Affairs medical center who presented for major elective noncardiac surgery. Preoperative frailty was assessed with the Risk Analysis Index RAI a item questionnaire and the records of all frail patients as determined by a certain RAI score were flagged for administrative review by the chief of surgery or designee before the scheduled operation. On the basis of this review clinicians from surgery anesthesia critical care and palliative care were notified of the patients frailty and associated surgical risks if indicated perioperative plans were modified based on team input. The researchers found that overall day mortality decreased from . percent  of  patients to . percent  of  patients after FSI implementation. Improvement was greatest among frail patients . percent to . percent although mortality rates also decreased among the robust patients . percent to . percent. The magnitude of improvement among frail patients increased at  and  days. The ultimate cause of the survival benefit is likely multifactorial including changes in preoperative decision making intraoperative management and postoperative rescue the authors write. This study reveals the feasibility of facilitywide frailty screening in elective surgical populations. It also suggests the potential to improve postoperative survival among the frail through systematic administrative screening review and optimization of perioperative plans. The absolute reduction in day mortality among frail patients was more than  percent with improvement remaining robust even after controlling for age frailty and predicted mortality. JAMA Surgery. Published online November  .doi.jamasurg... This study is available preembargo at the For The Media website httpmedia.jamanetwork.com. Editors Note This investigation was supported by a grant from the U.S. Department of Veterans Affairs Veterans Health Administration Office of Research and Development Health Services Research and Development. Please see the article for additional information including other authors author contributions and affiliations financial disclosures etc."