Frailty, as measured by slow gait speed, is a powerful predictor of mortality and major morbidity that can improve surgical risk stratification in older adults undergoing cardiac surgery.
Does frailty assessment measured by gait speed improve risk stratification for mortality and major morbidity in older adults being considered for cardiac surgery?
Incorporating gait speed as a measure of frailty into preoperative assessment can improve risk stratification for older adults undergoing cardiac surgery.
Frailty is a state of late life decline and vulnerability, typified by physical weakness and decreased physiologic reserve. The epidemiology and pathophysiology of frailty share features with those of cardiovascular disease. Gait speed can be used as a measure of frailty and is a powerful predictor of mortality. Advancing age is a potent risk factor for cardiovascular disease and has been associated with an increased risk of adverse outcomes. Older adults comprise approximately half of cardiac surgery patients, and account for nearly 80% of the major complications and deaths following surgery. The ability of traditional risk models to predict mortality and major morbidity in older patients being considered for cardiac surgery may improve if frailty, as measured by gait speed, is included in their assessment. It is possible that in the future frailty assessment may assist in choosing among therapies (e.g., surgical vs. percutaneous aortic valve replacement for patients with aortic stenosis).
Michael A. Chen (Thu,) conducted a review in Frailty and cardiovascular disease in older adults undergoing cardiac surgery. Gait speed assessment vs. Traditional surgical risk scores was evaluated. Frailty, as measured by slow gait speed, is a powerful predictor of mortality and major morbidity that can improve surgical risk stratification in older adults undergoing cardiac surgery.
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