Article ; Online: Preoperative physical frailty assessment among octogenarians undergoing cardiac surgery: Upgrading the "eyeball" test.
The Journal of thoracic and cardiovascular surgery
2021 Volume 165, Issue 4, Page(s) 1473–1483.e9
Abstract: Objectives: There are many well-described, but as yet unproven, physical ability tools to assess frailty. The objective of this study was to evaluate the effectiveness of 4 preoperative physical tests in predicting mortality, morbidity, and functional ... ...
| Abstract | Objectives: There are many well-described, but as yet unproven, physical ability tools to assess frailty. The objective of this study was to evaluate the effectiveness of 4 preoperative physical tests in predicting mortality, morbidity, and functional outcomes among octogenarians undergoing cardiac surgery. Methods: Between 2016 and 2019, 200 patients aged 80 years or more undergoing elective cardiac surgery were prospectively recruited. Four physical tests were performed preoperatively: 5-m walk time, timed up-and-go, 5 time sit-to-stand, and handgrip strength tests. The primary end point was a composite of in-hospital mortality, neurologic, and pulmonary complications. Multivariate analysis was performed. Results: In-hospital mortality was 1.5%. Slow performance on the 5-m walk test (time ≥6.4 seconds) was the only independent predictor of the composite end point among the tests evaluated (odds ratio, 2.70; 95% confidence interval, 1.34-5.45; P = .006). At follow-up, patients with a slow 5-m walk test had a significantly lower midterm survival compared with patients with a normal test result (1-year survival 91.5% vs 98.7%, log-rank P = .03). Mean Physical and Mental Component Scores of the 12-item short form survey were 47.2 ± 8.3 and 53.6 ± 5.9, respectively, which are comparable to those of a general population aged more than 75 years. Conclusions: The 5-m walk time test is an independent predictor of a composite of in-hospital mortality and major morbidity, as well as midterm survival. This test could be used as a simple adjunctive preoperative tool for octogenarians undergoing cardiac surgery. |
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| MeSH term(s) | Aged, 80 and over ; Humans ; Frailty/complications ; Frailty/diagnosis ; Octogenarians ; Hand Strength ; Treatment Outcome ; Cardiac Surgical Procedures/adverse effects ; Postoperative Complications/diagnosis ; Postoperative Complications/etiology ; Postoperative Complications/epidemiology ; Risk Factors | |||||
| Language | English | |||||
| Publishing date | 2021-04-09 | |||||
| Publishing country | United States | |||||
| Document type | Journal Article | |||||
| ZDB-ID | 3104-5 | |||||
| ISSN | 1097-685X ; 0022-5223 | |||||
| ISSN (online) | 1097-685X | |||||
| ISSN | 0022-5223 | |||||
| DOI | 10.1016/j.jtcvs.2021.02.100 | |||||
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| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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