Accurate frailty measurement includes parameters beyond age and comorbidities, as frailty is multifactorial and entails additional domains such as the social, nutritional, cognitive, and functional.1,2 Both retrospective and prospective frailty screening tools have been developed during the past decade, with expanding literature showing that frailty is associated of a wide variety of adverse perioperative outcomes, including complications, mortality, higher healthcare utilization and cost.3-6

Approximately 10-20% of individuals older than 65 years are considered frail. It is projected that by 2040 the proportion of vascular surgery patients ages 65-84 years will double, likely resulting in a high prevalence of frailty.7,8 Moreover, compared to other surgical disciplines, vascular surgeons treat patients with a higher burden of comorbidities and functional/cognitive deficits6,9,10 who are more likely to experience adverse postoperative events.11,12 Current estimates suggest 20% to 60% of vascular surgery patients are frail, depending on the measures used and the cohort selection.4,13 Therefore, frailty assessment may serve as a practical tool for vascular surgeons in the preoperative setting to enhance risk-stratification of their patients, inform their treatment selection and guide shared decision making while performing routine surgical workup and evaluation. This scoping review discusses the different components of frailty, provides an updated overview of the commonly used assessment tools, and explores the utility of these instruments in predicting perioperative clinical outcomes in patients undergoing vascular interventions. Additionally, we highlight future directions for the role of frailty data in evaluating the appropriateness of care and decision-making for vascular surgery patients.