Frail Patients Are at Increased Risk for Mortality and Prolonged Institutional Care After Cardiac Surgery

Article

关键词: QUALITY-OF-LIFE;    NONCARDIAC SURGERY;    OLDER-ADULTS;    OCTOGENARIANS;    COMPLICATIONS;    OUTCOMES;    DISABILITY;    DISEASE;    PEOPLE;    INDEX;   

DOI  :  10.1161/CIRCULATIONAHA.108.841437

来源: SCIE

【 摘 要 】

Background-Frailty is an emerging concept in medicine yet to be explored as a risk factor in cardiac surgery. Where elderly patients are increasingly referred for cardiac surgery, the prevalence of a frail group among these is also on the rise. We assessed frailty as a risk factor for adverse outcomes after cardiac surgery. Methods and Results-Functional measures of frailty and clinical data were collected prospectively for all cardiac surgery patients at a single center. Frailty was defined as any impairment in activities of daily living (Katz index), ambulation, or a documented history of dementia. Of 3826 patients, 157 (4.1%) were frail. Frail patients were older, were more likely to be female, and had risk factors for adverse surgical outcomes. By logistic regression, frailty was an independent predictor of in-hospital mortality (odds ratio 1.8, 95% CI 1.1 to 3.0), as well as institutional discharge (odds ratio 6.3, 95% CI 4.2 to 9.4). Frailty was an independent predictor of reduced midterm survival (hazard ratio 1.5, 95% CI 1.1 to 2.2). Conclusions-Frailty is a risk for postoperative complications and an independent predictor of in-hospital mortality, institutional discharge, and reduced midterm survival. Frailty screening improves risk assessment in cardiac surgery patients and may identify a subgroup of patients who may benefit from innovative processes of care. (Circulation. 2010; 121: 973-978.)

【 授权许可】

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