Frailty as a Growing Challenge for Anesthesiologists

Results of a Dutch National Survey

A. Bouwhuis; C. E. van den Brom; S. A. Loer; C. S. E. Bulte


BMC Anesthesiol. 2021;21(307) 

In This Article


Study Population

The survey was distributed on the first day of the annual meeting of the Dutch Society of Anesthesiology in May 2019. All visitors were informed about the research activities during the first plenary session. Participants were either volunteering spontaneously or asked to participate by members of the research team. Only participants in possession of an active medical license as a physician or physician assistant and at the time of the survey working in the Netherlands were included. This study did not involve patients and did not subject participants to any conditions other than a short and one-time survey without questions of sensitive nature. Therefore, this survey is not covered by the Medical Research Involving Human Subjects Act (WMO) as described in Article 1b.[13] As a consequence, formal approval of the Institutional Ethics Board was not required by Dutch law. Written informed consent as described in WMO Article 1v was therefore not obligated.[13] All participants were however fully informed about the nature and purpose of the survey and provided verbal informed consent prior to filling out the survey. After data collection responses were anonymized.


A fifteen-item paper survey was designed by the authors, because no validated instrument fulfilled the objective. The full questionnaire can be found in the supplement [see supplement A]. The first section included closed-ended questions on self-reported competence on identification of frailty, acquaintance with local protocols and attitude towards the increasing amounts of elderly patients presenting for surgery. The second part included questions on demographic features of the participant such as job position, experience and type of hospital.

Data Extraction and Statistical Analysis

As a result of the explorative nature of the survey no power calculation was conducted beforehand. The collected data was entered and analyzed by the first author in Microsoft Excel (Version 16 for Mac, Microsoft Corp, Redmond, Washing, USA), after which the responses were anonymized. Following data extraction, answers were coded as true or false (or unknown). If multiple answers were given the total number of replies to each question was used as the denominator. Incomplete forms were not excluded. Opinion-based and demographic variables were presented as categorical variables. Graphs were made using Graphpad Prism (Version 8, Graphpad Software, San Diego, California, USA). The full data extract is added as additional material [see supplement B].