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How Can We Best Measure Frailty in Cardiosurgical Patients?

Background: Frailty is gaining importance in cardiothoracic surgery and is a risk factor for adverse outcomes and mortality. Various frailty scores have since been developed, but there is no consensus which to use for cardiac surgery. Methods: In an all-comer prospective study of patients presenting...

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Autores principales: Laux, Magdalena L., Braun, Christian, Schröter, Filip, Weber, Daniela, Moldasheva, Aiman, Grune, Tilman, Ostovar, Roya, Hartrumpf, Martin, Albes, Johannes Maximilian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10140958/
https://www.ncbi.nlm.nih.gov/pubmed/37109346
http://dx.doi.org/10.3390/jcm12083010
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author Laux, Magdalena L.
Braun, Christian
Schröter, Filip
Weber, Daniela
Moldasheva, Aiman
Grune, Tilman
Ostovar, Roya
Hartrumpf, Martin
Albes, Johannes Maximilian
author_facet Laux, Magdalena L.
Braun, Christian
Schröter, Filip
Weber, Daniela
Moldasheva, Aiman
Grune, Tilman
Ostovar, Roya
Hartrumpf, Martin
Albes, Johannes Maximilian
author_sort Laux, Magdalena L.
collection PubMed
description Background: Frailty is gaining importance in cardiothoracic surgery and is a risk factor for adverse outcomes and mortality. Various frailty scores have since been developed, but there is no consensus which to use for cardiac surgery. Methods: In an all-comer prospective study of patients presenting for cardiac surgery, we assessed frailty and analyzed complication rates in hospital and 1-year mortality, as well as laboratory markers before and after surgery. Results: 246 included patients were analyzed. A total of 16 patients (6.5%) were frail, and 130 patients (52.85%) were pre-frail, summarized in the frail group (FRAIL) and compared to the non-frail patients (NON-FRAIL). The mean age was 66.5 ± 9.05 years, 21.14% female. The in-hospital mortality rate was 4.88% and the 1-year mortality rate was 6.1%. FRAIL patients stayed longer in hospital (FRAIL 15.53 ± 8.5 days vs. NON-FRAIL 13.71 ± 8.94 days, p = 0.004) and in intensive/intermediate care units (ITS/IMC) (FRAIL 5.4 ± 4.33 days vs. NON-FRAIL 4.86 ± 4.78 days, p = 0.014). The 6 min walk (6 MW) (317.92 ± 94.17 m vs. 387.08 ± 93.43 m, p = 0.006), mini mental status (MMS) (25.72 ± 4.36 vs. 27.71 ± 1.9, p = 0.048) and clinical frail scale (3.65 ± 1.32 vs. 2.82 ± 0.86, p = 0.005) scores differed between patients who died within the first year after surgery compared to those who survived this period. In-hospital stay correlated with timed up-and-go (TUG) (TAU: 0.094, p = 0.037), Barthel index (TAU-0.114, p = 0.032), hand grip strength (TAU-0.173, p < 0.001), and EuroSCORE II (TAU 0.119, p = 0.008). ICU/IMC stay duration correlated with TUG (TAU 0.186, p < 0.001), 6 MW (TAU-0.149, p = 0.002), and hand grip strength (TAU-0.22, p < 0.001). FRAIL patients had post-operatively altered levels of plasma-redox-biomarkers and fat-soluble micronutrients. Conclusions: frailty parameters with the highest predictive value as well as ease of use could be added to the EuroSCORE.
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spelling pubmed-101409582023-04-29 How Can We Best Measure Frailty in Cardiosurgical Patients? Laux, Magdalena L. Braun, Christian Schröter, Filip Weber, Daniela Moldasheva, Aiman Grune, Tilman Ostovar, Roya Hartrumpf, Martin Albes, Johannes Maximilian J Clin Med Article Background: Frailty is gaining importance in cardiothoracic surgery and is a risk factor for adverse outcomes and mortality. Various frailty scores have since been developed, but there is no consensus which to use for cardiac surgery. Methods: In an all-comer prospective study of patients presenting for cardiac surgery, we assessed frailty and analyzed complication rates in hospital and 1-year mortality, as well as laboratory markers before and after surgery. Results: 246 included patients were analyzed. A total of 16 patients (6.5%) were frail, and 130 patients (52.85%) were pre-frail, summarized in the frail group (FRAIL) and compared to the non-frail patients (NON-FRAIL). The mean age was 66.5 ± 9.05 years, 21.14% female. The in-hospital mortality rate was 4.88% and the 1-year mortality rate was 6.1%. FRAIL patients stayed longer in hospital (FRAIL 15.53 ± 8.5 days vs. NON-FRAIL 13.71 ± 8.94 days, p = 0.004) and in intensive/intermediate care units (ITS/IMC) (FRAIL 5.4 ± 4.33 days vs. NON-FRAIL 4.86 ± 4.78 days, p = 0.014). The 6 min walk (6 MW) (317.92 ± 94.17 m vs. 387.08 ± 93.43 m, p = 0.006), mini mental status (MMS) (25.72 ± 4.36 vs. 27.71 ± 1.9, p = 0.048) and clinical frail scale (3.65 ± 1.32 vs. 2.82 ± 0.86, p = 0.005) scores differed between patients who died within the first year after surgery compared to those who survived this period. In-hospital stay correlated with timed up-and-go (TUG) (TAU: 0.094, p = 0.037), Barthel index (TAU-0.114, p = 0.032), hand grip strength (TAU-0.173, p < 0.001), and EuroSCORE II (TAU 0.119, p = 0.008). ICU/IMC stay duration correlated with TUG (TAU 0.186, p < 0.001), 6 MW (TAU-0.149, p = 0.002), and hand grip strength (TAU-0.22, p < 0.001). FRAIL patients had post-operatively altered levels of plasma-redox-biomarkers and fat-soluble micronutrients. Conclusions: frailty parameters with the highest predictive value as well as ease of use could be added to the EuroSCORE. MDPI 2023-04-20 /pmc/articles/PMC10140958/ /pubmed/37109346 http://dx.doi.org/10.3390/jcm12083010 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Laux, Magdalena L.
Braun, Christian
Schröter, Filip
Weber, Daniela
Moldasheva, Aiman
Grune, Tilman
Ostovar, Roya
Hartrumpf, Martin
Albes, Johannes Maximilian
How Can We Best Measure Frailty in Cardiosurgical Patients?
title How Can We Best Measure Frailty in Cardiosurgical Patients?
title_full How Can We Best Measure Frailty in Cardiosurgical Patients?
title_fullStr How Can We Best Measure Frailty in Cardiosurgical Patients?
title_full_unstemmed How Can We Best Measure Frailty in Cardiosurgical Patients?
title_short How Can We Best Measure Frailty in Cardiosurgical Patients?
title_sort how can we best measure frailty in cardiosurgical patients?
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10140958/
https://www.ncbi.nlm.nih.gov/pubmed/37109346
http://dx.doi.org/10.3390/jcm12083010
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