Key result
Fried Frailty Phenotype best predicts older cardiac surgery outcomes, with zero mortality in non-frail patients.
Why the study?
Frailty assessment for risk prediction is suggested in elderly patients undergoing cardiac surgery, prompting a comparison of five different frailty tests.
Which frailty score best predicts postoperative outcomes and mortality in patients aged ≥65 years undergoing cardiac surgery?
Observational (n=140)
Which frailty score best predicts postoperative outcomes and mortality in patients aged ≥65 years undergoing cardiac surgery?
Effect estimate: RR 0.9-4
p-value: p=<0.05
In elderly patients undergoing cardiac surgery, the Fried Frailty Phenotype is the most sensitive test for identifying non-frail patients and predicting mortality.
May refine preoperative risk stratification in elderly cardiac surgery; hypothesis-generating and requires prospective validation.
Background: Frailty assessment for risk prediction is suggested in elderly patients undergoing cardiac surgery. We aimed to compare five different frailty tests. Methods: Relation of Edmonton Frailty Score (EFS), Fried Frailty Phenotype (FFP), FRAIL (Fatigue, Resistance, Ambulation, Illness, and Loss of weight), Katz and hand grip strength (HGS) tests to each other, postoperative outcomes and mortality rates were evaluated prospectively in 140 consecutive patients aged ≥65 years. Results: The median follow-up period was 880.5 (range, 0 to 1,237) days with higher EFS and FFP scores in non-survivors (p<0.05). Patients with any complication had higher EFS (p=0.002), FFP (p=0.004) and FRAIL (p=0,006) scores. Compared to non-frail patients, frail patients' NYHA capacity, EuroSCORE II and STS mortality risks were higher; hemoglobin values and HGS were lower with EFS, FFP, and FRAIL tests. Frail patients' hospitalization periods with EFS (p=0.003) and intensive care unit stay with FFP (p=0.029) were longer. No mortality was observed in non-frail patients according to the FFP test. The Kaplan-Meier (KM) log-rank survival curves showed significant differences in favor of non-frail subgroups according to EFS, FFP and HGS tests (p<0.05). Relative risks for mortality in frail and pre-frail patients were between 0.9 and 4. The FFP was the most sensitive test (area under curve=0.721). There was discordance rather than concordance among five different tests (Kappa <0.411). Conclusion: For patients aged ≥65 years undergoing heart surgery the FFP can be used safely to determine non-frail patients. Although the EFS seems to be promising to identify frail patients, further large-scale studies using various tests are needed to predict an optimal cut-off value for this patient population.
No takes yet. Share an insight, caveat, or question.
Babaroğlu et al. (2025) conducted an observational in Cardiac surgery (n=140). Frailty assessment (EFS, FFP, FRAIL, Katz, HGS) vs. Comparison among tests was evaluated on Postoperative outcomes and mortality rates (RR 0.9-4, p=<0.05). The Fried Frailty Phenotype was the most sensitive test (AUC=0.721) for predicting outcomes in cardiac surgery patients aged ≥65 years, with zero mortality observed in the non-frail subgroup.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: