Perioperative medicine & outcomes
Difficulty climbing stairs or walking one block on the FRAIL scale is associated with adverse postoperative outcomes in older surgical patients
Authors' conclusion
Of the five FRAIL scale questions, difficulty climbing one flight of stairs (resistance) was most associated with 30-day postoperative outcomes, followed by difficulty walking one block (ambulation). In busy preoperative clinics, these two yes/no questions may offer a quick and practical screening approach for identifying high-risk patients and those in need of prehabilitation.
Study context
- Population
- Surgical participants aged ≥65 years from the Postoperative Functional Disability in Unrecognized Cognitive Impairment (POF) and Detection of Cognitive Impairment (Detect-CI) studiessurgical participants aged ≥65 years included in the analysis
- Participants
- 677 participants
- Comparison
- Associations between frailty status and individual FRAIL questions with postoperative outcomes
Methodological detailsmultiplicity-adjusted multivariable logistic and linear regression models
- Multiplicity-adjusted multivariable logistic and linear regression models
Primary result
As reported in the abstract
30-day non-home discharge · 30-day
Odds ratio (95% CI)
Difficulty with resistance (Q2)higher odds with difficulty with resistance; comparator not stated
2.47(1.43–4.33)
Inability to walk one block (Q3: ambulation)higher odds with inability to walk one block; comparator not stated
2.93(1.67–5.31)
Further findings
Composite adverse outcomes
| OR (95% CI) | ||
|---|---|---|
| Difficulty with resistance (Q2) | 1.68 (1.14–2.49) | |
| 0.512Odds ratio (log scale) |
Hospital stay
| β (95% CI) | |
|---|---|
| Difficulty with resistance (Q2)22% longer hospital stay | 0.20 (0.08–0.32) |
| Inability to walk one block (Q3: ambulation)19% longer hospital stay | 0.18 (0.06–0.29) |
- Composite adverse outcomes: higher odds with difficulty with resistance; comparator not stated
Individual FRAIL questions and postoperative outcomes
- Inability to climb one flight of stairs (Q2: resistance) was most associated with postoperative outcomes among the five individual FRAIL questions
Original publication
Difficulty climbing stairs or walking one block on the FRAIL scale is associated with adverse postoperative outcomes in older surgical patients. J Clin Anesth. Published 8 October 2026. doi:10.
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