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Revista Colombiana de Cardiología
Print version ISSN 0120-5633
Abstract
LEMUS BARRIOS, Gustavo Alexis; CARDENAS CASTELLANOS, Juan Mauricio; CURCIO BORRERO, Carmen Lucía and MORENO GOMEZ, German Alberto. Effects of frailty on the adverse outcomes of cardiac surgery in the elderly. Rev. Colomb. Cardiol. [online]. 2020, vol.27, n.4, pp.250-261. Epub June 21, 2021. ISSN 0120-5633. https://doi.org/10.1016/j.rccar.2018.11.005.
Introduction:
Frailty is a common condition in the elderly patient, and is noted for its vulnerability for adverse outcomes in health, including those caused by cardiac surgery.
Objective:
To establish the prevalence of frailty in the pre-surgical context of the elderly subjected to cardiac surgery, as well as to establish the risk of adverse outcomes due to this condition.
Method:
An analytical cohort study was performed in order to evaluate frailty in 66 elderly patients subjected to cardiac surgery, using the physical phenotype of frailty described by Fried. A follow-up was made at 30 days, during which the frailty prevalence was established, as well the risk of adverse outcomes of the cardiac surgery due to this condition.
Results:
The age of the patients varied between 60 and 83 years, with a median of 70.5 years. The prevalence of frailty was 31.8%. Frailty increased the following post-surgical adverse outcomes: death (P = .001), longer ventilation time (P = .001), prolonged use of vasoactive drugs (P = .001), and infection of the surgical site (P = .004). The mortality risk due to frailty was higher than that of the usual evaluation scores such as Euro SCORE II (HR 5.49; 95% CI; 1.0-28.5 vs. HR 1.17: 95% CI; 1.0-1.29).
Conclusion:
Frailty is a common condition in the elderly patient subjected to cardiac surgery, and increases the risk of adverse events, particularly, mortality. It is recommended to use measurements of frailty in the pre-surgical protocol of the elderly patient.
Keywords : Frailty; Elderly; Cardiac surgery.