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. 2024 Aug;54(8):882-891.
doi: 10.1007/s00595-024-02807-z. Epub 2024 Mar 4.

Impact of frailty and prefrailty on the mid-term outcomes and rehabilitation course after cardiac surgery

Tasuku Honda  1 , Hirohisa Murakami  2 , Hiroshi Tanaka  2 , Yoshikatsu Nomura  2 , Toshihito Sakamoto  2 , Naomi Yagi  3
Affiliations

Impact of frailty and prefrailty on the mid-term outcomes and rehabilitation course after cardiac surgery

Tasuku Honda et al. Surg Today. 2024 Aug.

Abstract

Purpose: This study examined the impact of frailty and prefrailty on mid-term outcomes and rehabilitation courses after cardiac surgery.

Methods: A total of 261 patients (median age: 73 years; 30% female) who underwent elective cardiac surgery were enrolled in this study. The Japanese version of the Cardiovascular Health Study Frailty Index classified 86, 131, and 44 patients into frailty, prefrailty, and robust groups, respectively. We examined the recovery of walking ability, outcomes at discharge, mid-term all-cause mortality, and rehospitalization related to major adverse cardiovascular and cerebrovascular events (MACCE) across the three cohorts.

Results: The 3-year survival rates in the frailty, prefrailty, and robust groups were 87%, 97%, and 100%, respectively (p = 0.003). The free event rates of all-cause mortality and re-hospitalization related to MACCE were 59%, 79%, and 95%, respectively (p < 0.001), with a graded elevation in adjusted morbidity among patients in the prefrailty (hazard ratio [HR], 4.57; 95% confidence interval [CI], 1.08-19.4) and frailty (HR, 9.29; 95% CI 2.21-39.1) groups. Patients with frailty also experienced a delayed recovery of walking ability and a reduced number of patients with frailty were discharged home.

Conclusion: Frailty and prefrailty adversely affect the mid-term prognosis and rehabilitation course after cardiac surgery.

Keywords: Cardiac surgery; Frailty; Morbidity; Mortality; Rehabilitation.

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Conflict of interest statement

The authors declare no financial conflicts of interest that warrant disclosure.

Figures

Fig. 1
Fig. 1
Flow diagram of study enrollment
Fig. 2
Fig. 2
Kaplan–Meier curves for all-cause death according to the frailty assessment
Fig. 3
Fig. 3
Kaplan–Meier curves for all-cause death and readmission related to major adverse cardiovascular and cerebrovascular events according to the frailty assessment
See this image and copyright information in PMC

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