Real-world data on incidence of frailty in cardiac surgical patients and its impact on quality of life: An observational feasibility study

Background: An improvement in quality of life (QOL) is increasingly being perceived as a quality indicator after surgical interventions, cardiac surgery being no exception. There is scarce literature on whether frailty alters this expected change in QOL. Objective: To assess the baseline frailty and QOL of cardiac surgical patients and the impact of frailty on the QOL patterns in the cardiac surgical population presenting to a tertiary care facility in south India. Materials and Methods: Prospective observational pilot study. Of the 60 patients recruited, 41 patients were assessed for baseline frailty and 37 for change in QOL 3 months after cardiac surgery. Frailty was assessed using the Fried frailty test. Baseline QOL and QOL after 3 months of surgery were calculated with the Short Form-36 questionnaire under its eight domains. Results: The median values of QOL among cardiac surgical patients are 50 and 66, respectively, for role limitation due to physical health and role limitation to emotional health, as against above 70 each in the community. Other domains of QOL were comparable with the general population. There is no change in QOL noted in the nonfrail 3 months after cardiac surgery. The frail showed an improvement in the domain of general health. Prefrail showed an improvement in domains of pain and general health but a decline in physical and emotional well-being after cardiac surgery. Conclusion: Though this is a pilot study and will be followed by a future larger study, it still does give the following clues: QOL scores in cardiac patients are lower than in the general population, and the frail benefit from cardiac surgery as it improves their QOL.