Frailty is also associated with an increased cost of elective surgical care. Two simple-to-use frailty assessments are the Clinical Frailty Scale (CFS) and the Groningen Frailty Indicator (GFI). Each of these assessments can be rapidly performed and have been validated with multiple cohorts. Sarcopenia is the age-related loss of muscle mass and function.

It is often associated with physical frailty, yet being clinically frail is not always a prerequisite for a sarcopenia diagnosis. It is also associated with malnutrition, although the two entities can occur separately. Muscle function is often measured through hand grip strength, while lower extremity and torso muscle mass can be evaluated through numerous mechanisms, including computerized tomography (CT) morphometric analysis. Sarcopenia has been associated with an increased risk of postoperative complications in patients undergoing gastrointestinal tumor resection, and it has a potential role in preoperative risk stratification if both muscle mass and function are assessed. Malnutrition refers to deficiencies, imbalances, or excesses in a person’s intake of energy and nutrients. In patients undergoing major abdominal surgery, malnutrition is associated with worse outcomes, including increased lengths of stay, increased in-hospital mortality rates, and higher costs of care. The identification of malnutrition often relies on clinical screening tools that are reliant on various amounts of subjective recall. A promising new strategy for making an objective diagnosis of dietary patterns that indicate a risk for malnutrition is urine metabolomics analysis.

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