University of Lynchburg DMSc Doctoral Project Assignment Repository

University of Lynchburg DMSc Doctoral Project Assignment Repository


Cardiothoracic Surgery


Tom Colletti



Background: The purpose of this study is to determine if preoperative assessment of frailty in adult patients undergoing cardiac surgery can be predictive of length of stay and/or discharge destination. Standard risk stratification models in cardiac surgery do not include objective measures of frailty. The question for this author is, can frailty in conjunction with current risk stratification methods be used as a predictor of length of stay and discharge destination in patients undergoing open cardiac surgery?

Method: A systematic literature review of articles encompassing frailty as a post-operative predictive measure in patients undergoing cardiac surgery was performed. PubMed was the primary database used. Search terms included Frailty, Cardiac Surgery, Length of Stay, and Discharge Destination. Search results were limited to articles published in the last ten years. Results: Five articles were selected that evaluated the relationship between frailty, cardiac surgery patients, and the predictive capabilities of current surgical risk stratification with and without frailty indices. Two articles, both systematic reviews, determined that frailty increased the risk of poor postoperative outcomes and further study was required to determine the use of frailty and a predictor of postoperative outcomes.3,4 The remaining three studies discussed the relationship between frailty and post-operative outcomes and the need for frailty indices which more clearly define frailty.

Conclusion: This review concludes that frailty is poorly defined by many frailty indices. Further study is required to determine how best to define and assess frailty in adult patients undergoing cardiac surgery.


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