Assessment of preoperative frailty in adults undergoing cardiac surgery
Keywords:
Frailty, Thoracic Surgery, Preoperative PeriodAbstract
INTRODUCTION: The identification of preoperative frailty in patients undergoing cardiac surgery can be important for prognostic and postoperative recovery purposes, assisting in the conduct to be taken, such as pre-qualification, predicting perioperative risks, prudence in risks, prudence in more invasive therapies or procedures, and shortand long-term post-operative care needs. Objective: To estimate the prevalence of preoperative frailty of patients undergoing cardiac surgery, based on the 5 meters walking test. Methods: A retrospective study based on the institutional database of Encore Hospital, in which 91 adult patients who had undergone cardiovascular surgery were evaluated cardiovascular surgery, between the months of March 2019 and June 2023, being weighted the preoperative frailty of the patients by the 5 meters walking test. Results: 77 patients (84.6%) were the classification of non-frail in the pre-anesthetic evaluation, compared to 14 patients (15.4%) were considered frail, 13 of whom were aged 60 or over. were aged 60 or over. Conclusion: The presence of frailty is associated with a higher risk of morbidity, mortality and utilization of health services, demonstrating health services, demonstrating that the assessment of frailty should be explored in preoperative assessments for elective cardiac surgery.
References
Pereira EMP, Melo MPLB, De Armond LS, Souza AAB, Silva CR. Relação entre índice de fragilidade em idosos submetidos a cirurgia eletiva e complicações pós-operatórias. Rev HUGV [Internet]. 2023 Sep 20 [Cited 2024 Aug 20];22(1):10937. Available from: https://periodicos.ufam.edu. br/index.php/revistahugv/article/view/10937/version/17217doi: 10.60104/revhugv10937.
Cappe M, Laterre PF, Dechamps M. Preoperative frailty screening, assessment and management. Curr Opin Anaesthesiol [Internet]. 2023 Feb [Cited 2024 Aug 20];36(1):83-8. Available from: https://journals.lww.com/co-anesthesiology/fulltext/2023/02000/preoperative_frailty_screening,_assessment_and.16.aspx. doi: 10.1097/ACO.0000000000001221.
Sepehri A, Beggs T, Hassan A, Rigatto C, Shaw-Daigle C, Tangri N, Arora RC. The impact of frailty on outcomes after cardiac surgery: a systematic review. J Thorac Cardiovasc Surg [Internet]. 2014 Aug 7 [Cited 2024 Aug 20];148(6):3110-7. Available from: https://www.jtcvs.org/article/ S0022-5223(14)01067-8/fulltext. doi: 10.1016/j.jtcvs.2014.07.087.
Henry L, Halpin L, Barnett SD, Pritchard G, Sarin E, Speir AM. Frailty in the cardiac surgical patient: comparison of frailty tools and associated outcomes. Ann Thorac Surg [Internet]. 2019 Apr 3 [Cited 2024 Aug 20];108(1):16-22. Available from: https://www.annalsthoracicsurgery.org/ article/S0003-4975(19)30438-2/fulltext. doi: 10.1016/j.athoracsur.2019.03.009.
Montgomery C, Stelfox H, Norris C, Rolfson D, Meyer S, Zibdawi M, Bagshaw S. Association between preoperative frailty and outcomes among adults undergoing cardiac surgery: a prospective cohort study. CMAJ Open [Internet]. 2021 Jul 20 [Cited 2024 Aug 20];9(3):E777-87. Available from: https://www.cmajopen.ca/content/9/3/E777. doi: 10.9778/cmajo.20200034.
Ad N, Holmes SD, Halpin L, Shuman DJ, Miller CE, Lamont D. The effects of frailty in patients undergoing elective cardiac surgery. J Card Surg [Internet]. 2016 Apr [Cited 2024 Aug 20];31(4):187-94. Available from: https://onlinelibrary.wiley.com/doi/10.1111/jocs.12699. doi: 10.1111/jocs.12699.
Miguelena-Hycka J, Lopez-Menendez J, Prada PC, Rodriguez-Roda J, Martin M, Vigil-Escalera C, Hernandez-Vaquero D, Miguelena JM, Silva J, Gonzalez-Colaço M. Influence of preoperative frailty on health-related quality of life after cardiac surgery. Ann Thorac Surg [Internet]. 2019 [Cited 2024 Aug 20];108(1):23-29. Available from: https://www.annalsthoracicsurgery.org/article/S0003-4975(19)30098-0/fulltext#%20. doi: 10.1016/j.athoracsur.2018.12.028.
Afilalo J, Alexander KP, Mack MJ, Maurer MS, Green P, Allen LA, Popma JJ, Ferrucci L, Forman DE. Frailty assessment in the cardiovascular care of older adults. J Am Coll Cardiol [Internet]. 2014 Mar 4 [Cited 2024 Aug 20];63(8):747-62. Available from: https://www.sciencedirect.com/ science/article/pii/S073510971306155X?via%3Dihub. doi: 10.1016/j.jacc.2013.09.070.
Kazui T, Hsu CH, Hamidi M, Acharya D, Shanmugasundaram M, Lee K, Chatterjee A, Bull D. Five-meter walk test before transcatheter aortic valve replacement and 1-year noncardiac mortality. JTCVS Open [Internet]. 2022 Aug 18 [Cited 2024 Aug 20];12:103-17. Available from: https:// www.jtcvsopen.org/article/S2666-2736(22)00313-8/fulltext. doi: 10.1016/j.xjon.2022.08.003.
Arai Y, Kimura T, Takahashi Y, Hashimoto T, Arakawa M, Okamura H. Preoperative frailty is associated with progression of postoperative cardiac rehabilitation in patients undergoing cardiovascular surgery. Gen Thorac Cardiovasc Surg [Internet]. 2019 Apr 9 [Cited 2024 Aug 20];67(11):917-924. Available from: https://link.springer.com/article/10.1007/s11748-019-01121-7. doi: 10.1007/s11748-019-01121-7.
Fhon JRS, Rodrigues APR, Santos JLF, Diniz MA, Dos Santos EB, Almeida VC, Giacomini SBL. Factors associated with frailty in older adults: a longitudinal study. Rev Saúde Pública [Internet]. 2018 Aug 3 [Cited 2024 Aug 20];52:1518-8787. Available from: https://www.revistas.usp.br/ rsp/article/view/148599. doi: 10.11606/S1518-8787.2018052000497.
Bagnall NM, Faiz O, Darzi A, Athanasiou T. What is the utility of preoperative frailty assessment for risk stratification in cardiac surgery? Interact Cardiovasc Thorac Surg [Internet]. 2013 Aug [Cited 2024 Aug 20];17(2):398-402. Available from: https://academic.oup.com/icvts/article/17/2/398/789880. doi: 10.1093/icvts/ivt197.
