Role of frailty and sarcopenia in predicting outcomes among patients undergoing gastrointestinal surgery

Table 4 Makary et al[22] did report on the surgical outcomes of a large cohort of older patients in which frailty was assessed using a frailty scale based on the fried frailty phenotype

Characteristic
Weakness	Weakness should be assessed by grip strength and measured directly with a hand held JAMAR dynamometer (Sammons, Preston Rolyan). Three serial tests of maximum grip strength with the dominant hand will be performed and a mean of the three values will be calculated and adjusted by body mass index and gender. Actual weakness will be defined in the lowest 20th percentile of a community dwelling adults of 65 yr and older
Shrinking	Shrinking should be defined through a self-report as unintentional weight loss above 10 pounds during the last year
Exhaustion	Exhaustion should be measured by responses following 2 statements from the modified 10 items Center for Epidemiological Studies - Depression scale: "I felt that everything I did was an effort and I could not get going" and "How often in the last week did you feel way?" and will be given the opportunity to reply with 0 = rarely or none of the time (< 1 d); 1 = some or a little time (1-2 d); 2 = a moderate amount of time (3-4 d); and 3 = most of the time. Patients answering either with 2 or 3 will be classified as exhausted
Low activity	Physical activities should be assessed using the Minnesota Leisure Time Activities Questionnaire which includes frequency and duration. The focus should be placed on activities in the past 2 wk prior to operation. Weekly tasks will be converted to equivalent kilocalories of expenditure, and individuals reporting a weekly kilocalorie expenditure in the lowest 20th percentile for their gender will be classified as having low activity
Slow walking speed	Walking speed should be measured combining 3 trials of walking 15 feet at a normal pace for the patient. Patients with a walking speed in the lowest 20th percentile, adjusted for gender and height, will be scored as having a slow walking speed