We recommend using the Clinical Frailty Scale if the preoperative anaesthesia physical examination reveals the presence of a frailty phenotype. We should ask for an evaluation from a geriatrician to improve the cognitive, nutritional and comorbidity status by delaying surgery (time-sensitive or elective procedures) whenever possible. (Evidence level:Low；Recommendation grade:Strong)

We recommend using the Clinical Frailty Scale because of its high feasibility and predictive values. (Evidence level:Low；Recommendation grade:Strong)

The role of prehabilitation should be established in noncardiac surgery patients. (Evidence level:moderate；Recommendation grade:weak)

 Nutritional support before surgery should be considered in noncardiac surgery patients. (Evidence level:Low；Recommendation grade:weak)

We do not recommend routine admission to the ICU for patients with stable cardiac diseases undergoing elective major surgery. Selective access to the ICU in this subset of patients following a multidisciplinary evaluation of the risk-to-benefit ratio might be more appropriate. (Evidence level:Low；Recommendation grade:Strong)

When a GLP-1 agonist is prescribed as a weekly injection and considering the long half-life of GLP-1 agonists, we recommend pausing GLP-1 agonists at least 1 week before a scheduled procedure requiring sedation/anaesthesia. If these drugs are given for obesity, then 2 weeks (three half-lives) are recommended. (Evidence level:very Low；Recommendation grade:weak)

If the medication is prescribed as daily oral or subcutaneous administration, we recommend pausing GLP-1 agonists on the day of the procedure. (Evidence level:very Low；Recommendation grade:weak)

There is no evidence to show that stopping these medications even 1 week before the procedure will eliminate the risk of delayed gastric emptying, despite following the usual fasting timing for surgery. (Evidence level:very Low；Recommendation grade:weak)

A clear fluid diet for 24 h before any procedure should be considered in patients taking GLP-1 agonists. (Evidence level:very Low；Recommendation grade:weak)

All patients taking GLP-1 agonists should be considered as at risk of having a full stomach despite a lack of gastrointestinal symptoms. (Evidence level:very Low；Recommendation grade:weak)