The Impact of Frailty on Functional Survival in Patients 1 Year After Cardiac Surgery

While it is being increasingly understood that frailty in the older adult patient undergoing cardiac surgery is associated with an increased rate of postoperative mortality, it is still unclear if the addition of frailty measures to existing risk-assessment tools contributes to an improved prediction of long-term disabilty. In a prospective observational cohort analysis of 188 older adult patients undergoing cardiac surgery,  Lytwyn and colleagues have sought to determine if a measurement of frailty (using either the Modified Fried Criteria, the Short Physical Performance Battery or the Clinical Frailty Scale) was effective in predicting one-year functional survival (defined as being alive at 1 year with a health-related quality of life score greater than 60 on the EuroQol-Visual Analogue Scale). The authors observed a 2-3 fold worse one-year functional survival in frail cardiac surgery patients, and the addition of any measure to the European System for Cardiac Operative Risk Evaluation II (EuroSCORE II) was associated with improved predictive value of negative outcomes.