Effect of Frailty on the Postoperative Outcome in Patients Undergoing Open Heart Surgery

Background: Frailty is commonly reported to be associated with the outcomes of various surgeries. Over 50% of cardiac surgery surgeries carried out in senior patients. A considerable rate of those patients are frail. Aim: To compare the outcomes after open heart surgery in frailty test positive adult patients. Patients and Methods: The study was a prospective study with 60 adult patients who underwent open heart surgery, divided into a frail group (n=33) and a non-frail group (n=27) according to the FRAIL index. Patients were followed up for 30 days after surgery and their mortality, stay in intensive care unit and complications immediately after surgery were noted. Results: There was a higher proportion of the female gender in the frailty group (39.39%) than in the non-frail group (14.81%). There was significant difference between the Mean EF% in frail (49.21±11.91) and non-frail (54.96±7.54%) patients. The prevalence of hypertension and T2DM was higher in frail patients (72.73% and 48.48%) than in non-frail (25.93% and 22.22%) and was significantly higher for hypertension. In frail patients, the mortality rate was 18.18% while in non-frail patients, there was zero mortality. Results of multivariate analysis showed that the mean duration of stay in the intensive care unit was significantly associated with frailty (OR 8.42, 95%CI 1.27-68.91, p=0.023) and mean length of stay in the ICU was 2.7±1.46 days in frail patients versus 2.07±0.27 days in non-frail patients also significant. Conclusions: Elderly women are more likely to be frail than men and frail patients had lower ejection fractions compared to robust patients. Hypertension is a strong contributor to the onset of frailty. Furthermore, frail elderly patients who receive open-heart surgery have increased risk of death and longer stays in the intensive care unit (ICU) than non-frail patients.