Before making decisions about cardiac surgery, clinicians and older patients should weigh frailty’s effects on potential outcomes, using validated assessment tools, researchers say.
There is substantial variation in the assessment of frailty status in older cardiac surgery patients, according to the researchers. In a meta-analysis, they sought to illuminate links between frailty and and patient-centered outcomes for such surgeries, including quality of life (QoL), discharge to a non-home destination and hospital readmissions.
Although frailty is recognized as an important risk marker for cardiac surgery, six different tools were used across the studies analyzed, making it difficult to make generalizations, investigators reported. Although evidence was therefore limited, they were able to determine that preoperative frailty is tied to readmission and discharge to a post-acute care facility after cardiac surgery, but may also be associated with improvements in quality of life.
“Accurate assessments of frailty are important in the preoperative setting, but a consistently validated tool should be used in this context, with perioperative involvement from the geriatrics team,” they wrote.
Ultimately, “frailty should be used in the shared decision process when discussing cardiac surgery with older patients,” they concluded.
The study was published in JAGS.
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