Pre-frailty status increases the risk of rehospitalization in patients after elective cardiac surgery without complication

ABSTRACT

ABSTRACT background and aim: It has been demonstrated that patients with pre­frailty have more adverse outcomes after cardiac surgery; however, data on prognosis and long­ term evolution in patients with pre­frailty after elective cardiac surgery without postoperative complications are still scarce. To evaluate the impact of pre­frailty status on functional survival in patients after elective cardiac surgery without surgical complications. METHODS: This was a retrospective study with 141 patients over 65 years old, with an established diagnosis of myocardial infarction or valve disease. Patients were evaluated by Clinical Frailty Scale (CFS) before surgery, according to the hospital protocol, and allocated into two groups non­frail (CFS, 1­3) and pre­frail (CFS = 4). Patients with adverse cardiovascular events during surgery or at intensive care unit (ICU), mechanical ventilation more than 24 hours, ICU length of stay more than 48 hours, and in­hospital complications were excluded. For all analyses, the statistical significance was set at 5% (P < .05). RESULTS: There were no differences in demographic, anthropometric, surgical procedure, or baseline data on ICU. Pre­frail patients had more adverse events during the 3­year follow­up period with rehospitalization compared to non­frail (39.4% vs 14.3%, respectively). Rehospitalizations in pre­frail patients were in the first year after cardiac surgery (P < .05), and higher cumulative events in pre­frail have occurred with increased odds ratio (OR) (2.828, 95% confidence interval [CI] 1.298­6.160; P = .001) and hazard ratio (HR) (3.560, 95% CI 1.508­84.04; P = .004). The OR and HR for stroke or death were similar between groups when analyzed separately. CONCLUSION: Pre­frail patients have more adverse events after elective cardiac surgery without complications when compared to non­frail patients.