EuroScore II and frailty scales showed low predictability for postoperative complications, while EuroScore II demonstrated the highest prognostic value for predicting in-hospital mortality (AUC 0.816) in elderly cardiac surgery patients.
Observational (n=57)
No
Do frailty scales (Edmonton Frail Scale, Clinical Frailty Scale) better predict postoperative outcomes compared to standard risk scales (CARE, EuroScore II) in elderly patients undergoing open heart surgery?
EuroScore II and frailty scales both offer prognostic value for postoperative outcomes in elderly cardiac surgery patients, though EuroScore II demonstrated the highest sensitivity for predicting in-hospital mortality.
Effect estimate: AUC 0.652 for Edmonton Frail Scale vs AUC 0.665 for EuroScore II
p-value: p=not significant
BACKGROUND: In the last year there has been an increasing interest for using frailty scales for risk stratification of elderly patients undergoing major surgery. We planned to compare two frailty scales with risk scales already used in cardiac surgery, to study which of these scores have better prognostic value predicting postoperative outcome in open heart surgery. METHODS: We conducted a prospective clinical trial, including 57 patients over 65 years. We calculated Cardiac Anesthesia Risk Evaluation score, EuroScore II, Clinical Frailty Scale, Edmonton Frail Scale for each patient and followed the postoperative complications, length of mechanical ventilation, length of stay in the intensive care unit and hospital, and in-hospital death related to these risk and frailty scores. RESULTS: Postoperative complications occurred in 25 patients (43.9%), while four patients (7%) died with multiple organ failure. All scales had low predictability for postoperative complications, but for length of mechanical ventilation we obtained positive correlations with EuroScore II, Edmonton Frail Scale and Clinical Frailty Scale. EuroScore II can also predict the length of stay in the intensive care unit. For postoperative deaths, the highest sensitivity had EuroScore II, followed by Clinical Frailty Scale and Edmonton Frail Scale. CONCLUSIONS: EuroScore II and the frailty scales have an increased prognostic value regarding the postoperative outcome of patients (length of mechanical ventilation and in-hospital mortality), the EuroScore II can predict the length of stay in the intensive care unit as well.
Kovács et al. (Sun,) conducted a observational in Open heart surgery (n=57). Frailty scales (Edmonton Frail Scale, Clinical Frailty Scale) vs. Surgical risk scales (CARE, EuroScore II) was evaluated on Prediction of postoperative complications (AUC 0.652 for Edmonton Frail Scale vs AUC 0.665 for EuroScore II, p=not significant). EuroScore II and frailty scales showed low predictability for postoperative complications, while EuroScore II demonstrated the highest prognostic value for predicting in-hospital mortality (AUC 0.816) in elderly cardiac surgery patients.