Prognostic role of frailty in early and long-term prognosis after coronary artery bypass grafting

Objective. To assess the role of frailty in complications and adverse outcomes after coronary artery bypass grafting (CABG) in early and long-term follow-up period considering the diagnostic algorithm presented in the Russian clinical guidelines on frailty. Material and methods. The study included 387 coronary artery disease (CAD) patients admitted for CABG. A multistage algorithm including a questionnaire “Age is not a drawback”, short test battery for assessing physical functioning and brief cognitive screening test (Mini-Cog) was used to diagnose prefrailty and frailty in patients. Statistical analysis was carried out using the IBM SPSS Statistics software (ver. 26.0.0). Differences were significant at p<0.05. Results. The prevalence of frailty in CAD patients was 47%. There was 3 times lower number of patients with prefrailty (15%). Patients with prefrailty and frailty significantly more often had hypertension (p=0.001), smoking (p=0.008) and previous stroke (p=0.031). When analyzing the characteristics of intraoperative and early postoperative period after CABG, we found no significant differences in the incidence of complications and adverse outcomes. There were no significant between-group differences in the incidence of endpoints after a year. However, the number of cardiovascular deaths within a year after CABG was significantly higher among frail patients (2 (1.3%) deaths among patients without frailty, 3 (5.2%) deaths among patients with prefrailty and 7 (3.8%) deaths among patients with frailty, p=0.041, OR 1.4, CI 95%, 1.2—2.2). Conclusion. Frailty is a predictor of adverse outcomes in patients with CAD undergoing myocardial revascularization in early and long-term follow-up period.