Factors Associated With Frailty in Patients Undergoing Cardiac Surgery

Abstract

Background: Frailty may increase the risk of complications and mortality in patients undergoing cardiac surgery. Few studies on frailty and its associated factors have been conducted in these patients. Objective: The aim of this study was to explore frailty and related factors in patients undergoing cardiac surgery. Methods: A total of 154 patients undergoing cardiac surgery in northern Taiwan were recruited using a longitudinal study design and interviewed using structured questionnaires assessing physical activity, anxiety and depression, and social support before surgery and at 1 month and 3 months after surgery. Results: The prevalence of frailty in patients undergoing cardiac surgery was 16. 2%, 20.5%, and 16.6% before surgery and at 1 month and 3 months after surgery, respectively. Frail and prefrail patients undergoing cardiac surgery were more likely to be unemployed, have gout, have a higher New York Heart Association class, have preoperative dysrhythmia, undergo cardiopulmonary bypass, have a lower functional ability, have a higher European System for Cardiac Operative Risk Evaluation score, have a longer anesthesia time, have longer endotracheal tube and extracorporeal circulation times, have longer intensive care unit and hospital stays, have lower hemoglobin and albumin levels, have higher anxiety and depression levels, and have lower Mini-Mental State Examination scores. The significant predictors of prefrailty and frailty included unemployment, the presence of gout, higher New York Heart Association classes, less independence in activities of daily living, lower hemoglobin levels, and higher levels of depression. Conclusions: Frailty was associated with patients' functional status, perioperative conditions and psychosocial factors. Preoperative assessments of frailty and appropriate interventions are needed to improve frailty in patients undergoing cardiac surgery.

Risk factors for frailty in older adults

“…We eventually included 36 papers for this research. [4,5,8–41] The conditions in these studies and the clinical details of the patients are presented in Table 1. The search flow diagram is presented in Figure 1.…”

“…Finally, there are 36 studies [4,5,8–41] with 58,028 people included in this systematic-review. Data extraction included the baseline characteristics of aging adults, their lifestyle habits, their accompanying diseases, and whether they had experienced falls.…”

“…Several recent studies have identified severity of frailty across various conditions, including old age, female sex, and reduced concentration and motivation. [4,5,8–41] However, high-quality systematic reviews are still in demand. Overall, we conducted this project to study the risk factors for frailty.…”

Study on anxiety and depression in elderly patients with malignant liver tumor undergoing hepatectomy

“…A study shows that for patients undergoing elective non cardiac surgery, their preoperative anxiety and depression symptoms are related to their physical weakness [ 16 ]. Another study on cardiac surgery shows that the frailty is related to the perioperative psychological state of patients undergoing cardiac surgery [ 17 ]. Therefore, frailty in elderly patients should be evaluated preoperatively, and a geriatrician should be consulted for further evaluation if necessary.…”

Quality of life and activities of daily living one year after Coronary Artery Bypass Graft (CABG) surgery: a cross-sectional study

“…The range of scores of this questionnaire varies from 12 to 48. According to the scores they get in the questionnaire, people are classified into three categories: poor (12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24), average (25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36), and good (37)(38)(39)(40)(41)(42)(43)(44)(45)(46)(47)(48). Therefore, earning more points means a better quality of life.…”