The impact of frailty on functional survival in patients 1 year after cardiac surgery

Lytwyn, James; Stammers, Andrew N.; Kehler, D. Scott; Jung, Patrick; Alexander, Bryce; Hiebert, Brett; Dubiel, Chris; Kimber, Dustin E.; Hamm, Naomi C.; Clarke, Mekayla; Fraser, Carly; Pedreira, Brittany; Duhamel, Todd A.; Tangri, Navdeep; Arora, Rakesh C.

doi:10.1016/j.jtcvs.2017.06.040

Cited by 96 publications

(92 citation statements)

References 36 publications

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“…In the current era of cardiac surgery, those aged 75 years and older represent a growing subset of patients, and the level of frailty ranges between 25% and 50% of these patients depending on the type of assessment tool used. 1,2 Successful surgical correction of cardiac disease has the potential to restore biologic function and provide substantial benefit even for older adult patients. 3,4 However, conventional cardiac surgery is associated with substantial iatrogenic stress, which can affect outcomes.…”

Section: Supplemental Materials Is Available Onlinementioning

confidence: 99%

Frailty as a risk predictor in cardiac surgery: Beyond the eyeball test

Yanagawa

Graham

Afilalo

et al. 2018

The Journal of Thoracic and Cardiovascular Surgery

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Section: Supplemental Materials Is Available Onlinementioning

confidence: 99%

Frailty as a risk predictor in cardiac surgery: Beyond the eyeball test

Yanagawa

Graham

Afilalo

et al. 2018

The Journal of Thoracic and Cardiovascular Surgery

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“…5,6 It may be of greater interest to understand the effect of anaortic OPCAB on neuropsychiatric function within a frailer surgical patient population. 7 Important to note was the high frequency of antipsychotic use (approximately 24%) reported in this study. Current society guidelines recommend prescribing antipsychotics only for patients who have significant distress secondary to Off-pump CABG without aortic manipulation may have neurocognitive protective benefits.…”

Section: Delirium and Postoperative Cognitive Dysfunction (Pocd)mentioning

confidence: 69%

Commentary: Does a “less is more” approach reduce delirium in patients undergoing coronary artery bypass grafting?

Kehler

Arora

2021

The Journal of Thoracic and Cardiovascular Surgery

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“…Although this assertion is well established, the effect of a stressor event on long‐term pre‐frail patients was not clear. A previous study with frail patients undergoing cardiac surgery has shown that the presence of preoperative frailty is associated with a twofold to threefold to fivefold higher risk of poor functional survival 1 year after of cardiac surgery 2,18 …”

Section: Discussionmentioning

confidence: 99%

Pre‐frailty status increases the risk of rehospitalization in patients after elective cardiac surgery without complication

et al. 2020

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Background and Aim It has been demonstrated that patients with pre‐frailty have more adverse outcomes after cardiac surgery; however, data on prognosis and long‐term evolution in patients with pre‐frailty after elective cardiac surgery without postoperative complications are still scarce. To evaluate the impact of pre‐frailty status on functional survival in patients after elective cardiac surgery without surgical complications. Methods This was a retrospective study with 141 patients over 65 years old, with an established diagnosis of myocardial infarction or valve disease. Patients were evaluated by Clinical Frailty Scale (CFS) before surgery, according to the hospital protocol, and allocated into two groups: non‐frail (CFS, 1–3) and pre‐frail (CFS = 4). Patients with adverse cardiovascular events during surgery or at intensive care unit (ICU), mechanical ventilation more than 24 hours, ICU length of stay more than 48 hours, and in‐hospital complications were excluded. For all analyses, the statistical significance was set at 5% (P < .05). Results There were no differences in demographic, anthropometric, surgical procedure, or baseline data on ICU. Pre‐frail patients had more adverse events during the 3‐year follow‐up period with rehospitalization compared to non‐frail (39.4% vs 14.3%, respectively). Rehospitalizations in pre‐frail patients were in the first year after cardiac surgery (P < .05), and higher cumulative events in pre‐frail have occurred with increased odds ratio (OR) (2.828, 95% confidence interval [CI]: 1.298‐6.160; P = .001) and hazard ratio (HR) (3.560, 95% CI: 1.508‐84.04; P = .004). The OR and HR for stroke or death were similar between groups when analyzed separately. Conclusion Pre‐frail patients have more adverse events after elective cardiac surgery without complications when compared to non‐frail patients.

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The impact of frailty on functional survival in patients 1 year after cardiac surgery

Cited by 96 publications

References 36 publications

Frailty as a risk predictor in cardiac surgery: Beyond the eyeball test

Frailty as a risk predictor in cardiac surgery: Beyond the eyeball test

Commentary: Does a “less is more” approach reduce delirium in patients undergoing coronary artery bypass grafting?

Pre‐frailty status increases the risk of rehospitalization in patients after elective cardiac surgery without complication

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