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Cardiac surgery improves the postoperative frailty score of frail patients

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Abstract

Background

Cardiac surgery in frail patients has been reported to be associated with increased mortality and morbidity but may improve functional status of frail patients. Few studies have investigated the impact of cardiac surgery on the trajectory of postoperative frailty. We hypothesized that cardiac surgery in frail patients would improve frailty postoperatively.

Method

This study included 71 patients over 65 years old who were scheduled for cardiac surgery via sternotomy or thoracotomy. Frailty was prospectively evaluated using the Kihon Checklist (KCL) at 1 and 3 months postoperatively. Patients were divided into three groups based on the preoperative KCL score: nonfrail, prefrail, and frail. The interaction between the degree of preoperative frailty and the trajectory of postoperative KCL scores was assessed.

Results

The KCL score changed significantly over time (P < 0.001), and the KCL score trajectory differed significantly according to the degree of preoperative frailty (P for interaction = 0.003). In the frail group, the KCL score was significantly lower 3 months postoperatively than preoperatively (median 8, interquartile range [5, 9] versus median 9, interquartile range (9, 13), P = 0.029).

Conclusion

The trajectory of postoperative KCL scores differed significantly depending on the degree of preoperative frailty. At 3 months after cardiac surgery, the KCL score of frail patients was significantly improved, while that in nonfrail patients was significantly deteriorated.

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Data availability

The deidentified participant data will be shared on a request basis. Please directly contact the corresponding author to request data sharing.

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Authors and Affiliations

  1. Department of Anesthesiology, National Cerebral and Cardiovascular Center, Osaka, Japan

    Koya Shimakura, Kenji Yoshitani & Yoshihiko Ohnishi

  2. Department of Surgical Intensive Care, National Cerebral and Cardiovascular Center, 6-1 Kishibe Shinmachi, Suita, Osaka, 564-8565, Japan

    Kimito Minami

  3. Department of Anesthesiology and Pain Medicine, Gifu University Graduate School of Medicine, Gifu, Japan

    Hiroki Iida

Authors
  1. Koya Shimakura
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  2. Kimito Minami
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  3. Kenji Yoshitani
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  4. Yoshihiko Ohnishi
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  5. Hiroki Iida
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Correspondence to Kimito Minami.

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IRB information: This study protocol was approved by the Ethics Committee of the National Cerebral and Cardiovascular Center (registration number: M29-100).

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Shimakura, K., Minami, K., Yoshitani, K. et al. Cardiac surgery improves the postoperative frailty score of frail patients. J Anesth 36, 186–193 (2022). https://doi.org/10.1007/s00540-021-03025-4

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  • DOI: https://doi.org/10.1007/s00540-021-03025-4

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