The Impact of frailty on outcomes after cardiac surgery

Abstract

Introduction. Older adults make up an ever-increasing number of patients presenting for surgery and a significant percentage of these patients will be frail, with decreased reserve when confronted with perioperative stressors [1]. As the population ages, the rate of surgical procedures in the older population is rising. Patients of the same age do not all have the same risk [2]. Frailty has become an important topic in cardiac surgery, as the average age and complexity of patients has increased, and treatment options for cardiac disease have diversified – from medical management to minimally invasive procedures to cardiac surgery [3]. In an era that emphasizes value in medicine, identifying the most vulnerable patients, deciding an appropriate course of therapy, and targeting valuable resources are important priorities. The concept of frailty may play a key role in these processes. The issue is to disclose understanding of frailty in the perioperative period, as well as how this information might be used to improve outcomes for frail older adults, with a particular focus on cardiac surgery [1]. The identification and assessment of frailty may facilitate identification of vulnerable surgical patients so that appropriate surgical and anaesthetic management can be implemented. Frailty is increasingly recognized as a specific clinical condition associated with poorer outcomes in many areas of medicine and surgery [4]. It is important that cardiologists, anaesthesiologists and cardiothoracic surgeons are aware of how to assess frailty and of its potential impact on clinical outcomes. Aim: To determine the role of frailty assessment in patients undergoing cardiac surgical procedures Methods. The literature search was performed in the databases Pubmed, Science Direct, PLOS Google Scholar. Reviewed more than 25 literature reviews, published between 2009-2019. The analysis of the case report and the PICO questionnair[...].