Comprehensive frailty assessment with multidimensional frailty domains as a predictor of mortality among vascular and cardiac surgical patients

被引:0
|
作者
Szabo, Andras [1 ]
Szabo, Dominika [1 ,2 ]
Toth, Krisztina [1 ]
Szecsi, Balazs [1 ]
Szentgroti, Rita [1 ]
Nagy, Adam [3 ]
Eke, Csaba [1 ]
Sandor, Agnes [1 ,4 ]
Benke, Kalman [2 ]
Merkely, Bela [2 ]
Gal, Janos [4 ]
Szekely, Andrea [1 ,2 ]
机构
[1] Semmelweis Univ, Doctoral Sch Theoret & Translat Med, Budapest, Hungary
[2] Semmelweis Univ, Heart & Vasc Ctr, Budapest, Hungary
[3] Gottsegen Natl Cardiovasc Ctr, Budapest, Hungary
[4] Semmelweis Univ, Dept Anesthesiol & Intens Therapy, Budapest, Hungary
关键词
frailty; frailty assessment; frailty score; preoperative risk; risk strati fi cation; vascular surgery; cardiac surgery; AORTIC-VALVE-REPLACEMENT; OLDER-ADULTS; RISK; SURGERY; POSSUM; MORBIDITY; SURVIVAL; EVENTS;
D O I
10.1556/2060.2023.00195
中图分类号
Q4 [生理学];
学科分类号
071003 ;
摘要
Purpose: The frailty concept has become a fundamental part of daily clinical practice. In this study our purpose was to create a risk estimation method with a comprehensive aspect of patients' preoperative frailty. Patients and methods: In our prospective, observational study, patients were enrolled between September 2014 and August 2017 in the Department of Cardiac Surgery and Department of Vascular Surgery at Semmelweis University, Budapest, Hungary. A comprehensive frailty score was built from four main domains: biological, functional-nutritional, cognitive-psychological and sociological. Each domain contained numerous indicators. In addition, the EUROSCORE for cardiac patients and the Vascular POSSUM for vascular patients were calculated and adjusted for mortality. Results: Data from 228 participants were included for statistical analysis. A total of 161 patients underwent vascular surgery, and 67 underwent cardiac surgery. The preoperatively estimated mortality was notsignificantly different (median: 2.700, IQR (interquartile range): 2.000-4.900 vs. 3.000, IQR: 1.140- 6.000, P = 0.266). The comprehensive frailty index was significantly different (0.400 (0.358-0.467) vs. 0.348 (0.303-0.460), P = 0.001). In deceased patients had elevated comprehensive frailty index (0.371 (0.316-0.445) vs. 0.423 (0.365-0.500), P < 0.001). In the multivariate Cox model an increased risk for mortality in quartiles 2, 3 and 4 compared with quartile 1 as a reference was found (AHR (95% CI): 1.974 (0.982-3.969), 2.306 (1.155-4.603), and 3.058 (1.556-6. 010), respectively). Conclusion: The comprehensive frailty index developed in this study could be an important predictor of long-term mortality after vascular or cardiac surgery. Accurate frailty estimation could make the traditional risk scoring systems more accurate and reliable.
引用
收藏
页码:191 / 210
页数:20
相关论文
共 50 条
  • [31] Frailty as a Novel Predictor of Mortality and Hospitalization in Hemodialysis Patients of All Ages
    McAdams-DeMarco, M.
    Law, A.
    Salter, M.
    Gimenez, L.
    Jaar, B.
    Waltson, J.
    Segev, D.
    JOURNAL OF THE AMERICAN GERIATRICS SOCIETY, 2013, 61 : S8 - S8
  • [32] Combination of clinical frailty score and biomarkers as mortality predictor in hemodialysis patients
    Sophie, Cornet
    Kevin, Quinonez
    Xavier, Warling
    Jouret, Francois
    Cavalier, Etienne
    Delanaye, Pierre
    NEPHROLOGY DIALYSIS TRANSPLANTATION, 2024, 39
  • [33] Role of frailty assessment in patients undergoing cardiac interventions
    Rowe, Rebecca
    Iqbal, Javaid
    Murali-krishnan, Rachel
    Sultan, Ayyaz
    Orme, Rachel
    Briffa, Norman
    Denvir, Martin
    Gunn, Julian
    OPEN HEART, 2014, 1 (01):
  • [34] FRAILTY AS A PREDICTOR OF OUTCOME IN SURGICAL INTENSIVE CARE PATIENTS: A PILOT STUDY
    Cass, R. W.
    Lissauer, M.
    Buchanan, L. S.
    GERONTOLOGIST, 2014, 54 : 90 - 91
  • [35] A Vascular Quality Initiative frailty assessment predicts postdischarge mortality in patients undergoing arterial reconstruction
    Kraiss, Larry W.
    Al-Dulaimi, Ragheed
    Allen, Chelsea M.
    Mell, Matthew W.
    Arya, Shipra
    Presson, Angela P.
    Brooke, Benjamin S.
    JOURNAL OF VASCULAR SURGERY, 2022, 76 (05) : 1325 - +
  • [36] Inclusion of frailty as a predictor for adverse outcomes in elderly cardiac surgery patients
    Cavallaro, P. M.
    Chikwe, J.
    JOURNAL OF THE AMERICAN GERIATRICS SOCIETY, 2013, 61 : S7 - S7
  • [37] Frailty as a predictor of mortality among patients with COVID-19: a systematic review and meta-analysis
    Xiao-Ming Zhang
    Jing Jiao
    Jing Cao
    Xiao-Peng Huo
    Chen Zhu
    Xin-Juan Wu
    Xiao-Hua Xie
    BMC Geriatrics, 21
  • [38] Frailty as a predictor of mortality among patients with COVID-19: a systematic review and meta-analysis
    Zhang, Xiao-Ming
    Jiao, Jing
    Cao, Jing
    Huo, Xiao-Peng
    Zhu, Chen
    Wu, Xin-Juan
    Xie, Xiao-Hua
    BMC GERIATRICS, 2021, 21 (01)
  • [39] Elderly glioblastoma patients: role of multidimensional assessment of frailty in predicting outcomes
    Giaccherini, L.
    Ciammella, P.
    Galaverni, M.
    Manicone, M.
    Renna, I.
    Galeandro, M.
    Timon, G.
    Bellafiore, F.
    Ramundo, D.
    Vigo, F.
    Rosca, A.
    Palmieri, T.
    Ruggieri, M. P.
    Botti, A.
    Sghedoni, R.
    Cagni, E.
    Orlandi, M.
    Iori, M.
    Russo, M.
    Iotti, C.
    RADIOTHERAPY AND ONCOLOGY, 2019, 133 : S888 - S889
  • [40] A Longitudinal Study on the Association of Interrelated Factors Among Frailty Dimensions, Cognitive Domains, Cognitive Frailty, and All-Cause Mortality
    Chen, Jen-Hau
    Shih, Hua-San
    Tu, Jennifer
    Chiou, Jeng-Min
    Chang, Shu-Hui
    Hsu, Wei-Li
    Lai, Liang-Chuan
    Chen, Ta-Fu
    Chen, Yen-Ching
    JOURNAL OF ALZHEIMERS DISEASE, 2021, 84 (04) : 1795 - 1809