Frailty as a Predictor of Postoperative Outcomes in Invasive Cardiac Surgery: A Systematic Review of Literature.
Anna Peeler, Chandler Moser, Kelly T Gleason and 1 others
PMID 34016838WHAT IT FOUND
Preoperative frailty was associated with longer stay, complications, rehabilitation discharge, readmission, longer ventilation and functional decline after invasive cardiac surgery.
Only nine of nineteen studies found frailty linked to higher mortality.
Key findings
01Nine of 19 studies found a significant survival difference, and frail patients were found to have longer stays, more complications, more rehabilitation discharge, more readmissions, longer ventilation and more functional decline in studies that measured those outcomes.
02The review included 19 studies of 52,291 subjects using 17 frailty tools, and frailty prevalence varied from 9% to 61%.
03All included studies excluded emergency cardiac surgery, and the review excluded single-component frailty measures such as five-meter gait speed alone.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
Every included study excluded patients needing emergency cardiac surgery, so the findings do not apply to emergency operations. The review used 17 different frailty tools, and frailty prevalence varied from 9% to 61%, so it does not identify one best tool or a stable frailty rate. It excluded studies that used only one frailty item, such as five-meter gait speed alone, so it does not tell you whether a quick single-item screen works. The search was limited to English publications, so non-English studies may be missing. Most participants were male and older than 65, so results may not apply equally to women or younger patients. Only statistically significant results were discussed, so trends and null findings may be underrepresented. The review did not test whether frailty screening changes outcomes, and many studies were too small to show differences.
The easy way to misread this
Do not read this as proof that frailty caused worse outcomes or that screening will improve them. It is an association across observational studies, and only nine of nineteen studies found mortality differences.