Association of Preoperative Frailty and Postoperative Outcomes in Older Adults Undergoing Major Cardiac Procedures: A Systematic Review and Meta-Analysis.
Vetri Thangavelu, Ojas Bhatia, Anushka Hasija et al.
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In 30 seconds
This systematic review and random-effects meta-analysis examined preoperative frailty and postoperative outcomes in older adults undergoing major cardiac procedures. Nineteen studies included 11,667 patients, with a mean age of 71.9 ± 8.1 years; frailty prevalence was 16.8%. Frailty was associated with higher odds of 30-day mortality (OR, 3.58; 95% CI, 2.16-5.93; P <.001) and was also associated with delirium, infection, renal complications, longer hospital and ICU stays, and higher 1-year mortality. These findings identify frailty as a marker of increased postoperative risk in this population.
Key findings
- Preoperative frailty prevalence was 16.8% across the included studies.
- Frailty was associated with delirium (OR, 4.11; 95% CI, 2.00-8.45; P <.001) and infection (OR, 3.72; 95% CI, 2.27-6.12; P <.001).
- Frailty was associated with renal complications (OR, 2.72; 95% CI, 2.05-3.60; P <.001) and longer hospital and ICU stays.
- Frailty was associated with higher 30-day (OR, 3.58; 95% CI, 2.16-5.93; P <.001) and 1-year mortality (OR, 2.25; 95% CI, 1.56-3.25; P <.001).
Why it matters
Frailty was associated with several clinically consequential outcomes, including delirium, organ complications, prolonged hospital and ICU stays, and mortality. Recognising this risk profile can inform perioperative assessment and planning for older adults undergoing major cardiac procedures. The findings also highlight the importance of consistent frailty assessment when evaluating risk across this population.
What to keep in mind
The meta-analysis combined studies using different validated frailty instruments and included varied cardiac procedures; the abstract notes methodological inconsistency across frailty tools.