ABSTRACT NUMBER: FEGGETTER MEDAL FOR SENIOR TRAINEES (ST3+)_8
MAIN ABSTRACT TEXT
The currently available frailty scores only assess one or selected few of its components. This pilot study aims to assess the feasibility of comprehensively measuring frailty of elective cardiac surgery patients.
From December 2018 to September 2020, all cardiac surgery patients rg70 years underwent a comprehensive frailty assessment pre-operatively. 1 point each was assigned for slow gait speed, upper and lower extremity weakness, weight loss, exhaustion, anaemia, hypoalbuminaemia, malnutrition, cognitive impairment, and reduced activities of daily living and instrumental activities of daily living. Patients with a score rg4/11 were deemed as frail. Kaplan-Meier survival analysis and logistic regression were used to study whether the frailty score predicts outcomes.
82.1%(165/201) consecutively recruited patients completed the full assessment and underwent cardiac surgeries. 38.2%(63/165) patients, who were deemed frail, had increased risk of major complications (frail vs. non-frail: 23.8%(15/63) vs. 6.9%(7/102), p=0.002), longer ITU (2 [1-4] vs. 1 [1-3]days, p=0.002) and hospital stay (8 [6-13] vs. 6 [5-7]days, p<0.001), and poorer post-operative survival (log-rank test p=0.002).
Frailty predicts major complications (odds ratio (OR) 3.66, 95% confidence interval (CI) 1.27-10.54), ITU stay >3 days (OR 3.48, 95% CI 1.37-8.88) and hospital stay >10 days (OR 2.66, 95% CI 1.14-6.22), independent of age, sex, BMI, EuroSCORE II and operation type.
It is feasible to comprehensively evaluate patients’ frailty using the North East frailty score. This frailty score is superior than EuroSCORE II in predicting post-cardiac surgery outcomes, and provides additional information to facilitate the heart team to better risk stratify patients.