Frailty in Elderly Patients Undergoing Cardiac Surgery Increases Hospital Stay and 12-Month Readmission Rate

Lal, Sunil K.; Gray, Andrew; Kim, Eric; Bunton, Richard; Davis, Philip; Galvin, Ivor F.; Williams, Michael J.A.

doi:10.1016/j.hlc.2019.10.007

Cited by 31 publications

(40 citation statements)

References 35 publications

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“…Currently, there is no consensus on the use of EFS cut-off scores to define non-frail, vulnerable and frail among the clinicians globally. The most widely used classifications include a two cut-off point system dividing the elderly patients into non-frail (EFS < 5), vulnerable (EFS 6-7) and frail (EFS > 8) 31,35 and a four cut-off point system which separate the population into five categories like our study 11,36 . By having a more delicate classification system, we felt that the five-category system allows clinicians to risk stratify the patients with higher specificity based on their degree of frailty.…”

Section: Discussionmentioning

confidence: 99%

Assessment of predictive validity and feasibility of Edmonton Frail Scale in identifying postoperative complications among elderly patients: a prospective observational study

Hao

et al. 2020

Sci Rep

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Frailty is defined as diminished physiological reserve predisposing one to adverse outcomes when exposed to stressors. Currently, there is no standardized Frail assessment tool used perioperatively. Edmonton Frail Scale (EFS), which is validated for use by non-geriatricians and in selected surgical populations, is a candidate for this role. However, little evaluation of its use has been carried out in the Asian populations so far. This is a prospective observational study done among patients aged 70 years and above attended Preoperative Assessment Clinic (PAC) in Singapore General Hospital prior to major abdominal surgery from December 2017 to September 2018. The Comprehensive Complication Index (CCI) and Postoperative Morbidity Survey (POMS) were used to assess their postoperative morbidity respectively. Patient’s acceptability of EFS was measured using the QQ-10 questionnaire and the inter-rater reliability of EFS was assessed by Kappa statistics and Bland Altman plot. The primary aim of this study is to assess if frailty measured by EFS is predictive of postoperative complications in elderly patients undergoing elective major abdominal surgery. We also aim to assess the feasibility of implementing EFS as a standard tool in the outpatient preoperative assessment clinic setting. EFS score was found to be a significant predictor of postoperative morbidity. (OR 1.35, p < 0.001) Each point increase in EFS score was associated with a 3 point increase in CCI score. (Coefficient b 2.944, p < 0.001) EFS score more than 4 has a fair predictability of both early and 30-day postoperative complications. Feasibility study demonstrated an overall acceptance of the EFS among our patients with good inter-rater agreement.

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Section: Discussionmentioning

confidence: 99%

Assessment of predictive validity and feasibility of Edmonton Frail Scale in identifying postoperative complications among elderly patients: a prospective observational study

Hao

et al. 2020

Sci Rep

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“…Our study contributes to filling the gap of understanding if and how frailty states transition after AVR. Past literature demonstrates that patients who are deemed frail have a higher likelihood of experiencing mortality, morbidity, functional decline, and major adverse cardiac and cerebrovascular events following cardiac surgery [29,30]. Preoperative frailty assessment may therefore identify patients at increased risk.…”

Section: Discussionmentioning

confidence: 99%

Frailty Status and Patient-Reported Outcomes in Octogenarians Following Transcatheter or Surgical Aortic Valve Replacement

Frantzen

Eide

Fridlund

et al. 2021

Heart, Lung and Circulation

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“…A meta-analysis showed that FS and pre-frailty were associated with greater adjusted operative mortality and adjusted perioperative complications, and FS was associated with almost 5-fold risk of non-home discharge [ 49 ]. Preoperative FS also predicts prolonged respiratory therapy, prolonged stay in the intensive care unit, functional decline, postoperative delirium, reoperations, readmission rate, increased risk of institutional discharge, and early, mid-term, and late mortality [ 50 , 52 , 80 , 84 , 85 , 86 , 87 , 88 , 89 , 90 , 91 , 92 , 93 , 94 ].…”

Section: Fs and Cardiac Surgery And Tavimentioning

confidence: 99%

Frailty Syndrome in Older Adults with Cardiovascular Diseases–What Do We Know and What Requires Further Research?

Wleklik

Denfeld

Lisiak

et al. 2022

IJERPH

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Cardiovascular diseases (CVD) affect 60% of people over 60 years of age and are one of the main causes of death in the world. Diagnosed cardiovascular disease also triples the likelihood of Frailty syndrome (FS). FS has become increasingly relevant in cardiology and cardiac surgery and occurs in a significant number of patients with CVD, with prevalence ranging from 25% to 62%. Viewed in a multidimensional, biopsychosocial perspective, FS increases a patient’s vulnerability, making them susceptible to several adverse clinical outcomes. Frailty syndrome also is a predictor of mortality in patients with CVD regardless of age, severity of disease, multi-morbidity, and disability. Frailty syndrome potentially can be prevented in patients with CVD and its early identification is important to avoid the development of disability, dependence on others and reduced quality of life. The aim of this paper is to show the relationship between FS and specific CVDs (coronary artery disease, hypertension, atrial fibrillation, heart failure) and cardiac procedures (device implantation, cardiac surgery, and transcatheter aortic valve implantation). Furthermore, we highlight those areas that require further research to fully understand the relationship between FS and CVD and to be able to minimize or prevent its adverse effects.

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Frailty in Elderly Patients Undergoing Cardiac Surgery Increases Hospital Stay and 12-Month Readmission Rate

Cited by 31 publications

References 35 publications

Assessment of predictive validity and feasibility of Edmonton Frail Scale in identifying postoperative complications among elderly patients: a prospective observational study

Assessment of predictive validity and feasibility of Edmonton Frail Scale in identifying postoperative complications among elderly patients: a prospective observational study

Frailty Status and Patient-Reported Outcomes in Octogenarians Following Transcatheter or Surgical Aortic Valve Replacement

Frailty Syndrome in Older Adults with Cardiovascular Diseases–What Do We Know and What Requires Further Research?

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