The effect of frailty on postoperative recovery in patients with cardiovascular surgery

This study aimed to examine the impact of frailty on postoperative morbidity and mortality in patients undergoing cardiovascular surgery, questioning the adequacy of the preoperative American Society of Anesthesiologists (ASA) as the sole assessment tool. In a cohort of 76 patients undergoing cardiovascular interventions, we analyzed demographic data, Edmonton Frail Scale (EFS), ASA scores, Charlson Comorbidity Index values, surgery and hospitalization durations, intraoperative blood pressures, inotropic needs, erythrocyte transfusions, and pre/postoperative hemoglobin levels. Pearson chi-squared and Spearman tests were performed. Correlation of postoperative intensive care unit (ICU) stay, extubation time, ward stay, discharge status, morbidity rates, and ASA and EuroSCORE II results with EFS scores. The demographic profile indicated a mean age of 59.67 ± 13.02 years, with a majority of male patients (59.2%). Frailty status varied, with 48.7% non-frail, 26.3% vulnerable, 18.4% mildly frail, and 6.6% moderately frail. Surgical data revealed an average duration of 300.93 minutes and a mean ICU stay of 54.48 ± 101.16 hours. Statistical analysis showed significant differences in frailty levels based on initial morbidity (χ2 = 10.612, P = .014) but not in ASA score distribution by morbidity status (χ2 = 1.634, P = .442). A negative correlation was observed between EFS scores and hemoglobin levels, along with a positive correlation between the EuroSCORE II score and the duration of intubation, extubation, and ICU stay. Frailty significantly contributes to increased morbidity and necessitates evaluation alongside preoperative ASA scores to inform the need for prehabilitation. The ultimate goal extends beyond patient survival, aiming to ensure recovery while maintaining the quality of life and functional independence.