Can Frailty Index Factors Predict Postoperative Dispositional Outcomes in Cardiac Surgery?
Document Type
Conference Proceeding
Publication Date
10-12-2025
Abstract
With the aging population of the United States, increased pressure has been placed on research to determine the impact of patient frailty on healthcare outcomes. While standardized frailty indexes have been published, no gold standard exists for the field of cardiac surgery. This study aims to provide the groundwork for the development of a preoperative frailty metric that improves patient-centered outcome prediction to reduce preoperative stressors for frail patients and their families. The authors utilized programmed retrospective chart review and a multivariable logistic regression model with backwards variable selection to determine significant frailty variable relationships with desired patient-centered postoperative outcomes. Data was collected from two tertiary hospitals for patients who underwent surgical aortic valve replacement (SAVR) or coronary artery bypass grafting (CABG) between 2021 and 2023. Variables observed include age at admit, sex, serum albumin, hemoglobin level, body mass index (BMI), number of preoperative medications, number of comorbidities, postoperative discharge disposition, length of postoperative hospital stay and prescribed postoperative therapy regimen. Results depict significant utility in using serum albumin and hemoglobin to predict patient-centered dispositional outcomes as increasingly elevated values of both, increase patient odds to be discharged home postoperatively and to have below median hospital stays. Higher albumin levels were individually associated with increased odds of patients being prescribed home therapy regimens. Older age at admission and increasing numbers of comorbidities provide less clinical utility albeit both have significant associations with decreased odds of being discharged home postoperatively and receiving a home therapy prescription with longer than median hospital stays associated only with increased number of comorbidities. Female sex additionally resulted in patients having nearly 0.5 times the odds to receive home therapy prescriptions as their male counterparts despite no impact on discharge disposition or postoperative length of stay. With model predictability, results suggest feasibility in generating a frailty index tool capable of providing predictions for patient-centered outcomes in cardiac surgery in efforts to benefit patient education and reduce patient stressors. Further studies need to be conducted to identify valuable scales, mean values and critical values for determination of each variable's optimal clinical usage in predicting patient-centered outcomes. More studies should additionally be conducted prospectively and expanded to include other identified and more specific measures of frailty.
Recommended Citation
Whitton M, Navas-Blanco J. Can frailty index factors predict postoperative dispositional outcomes in cardiac surgery? Presented at: American Society of Anesthesiologists, The Anesthesiology Meeting; 2025 Oct 12; San Antonio, TX. Available from:https://www.abstractsonline.com/pp8/#!/21028/presentation/7791
Comments
American Society of Anesthesiologists, The Anesthesiology Annual Meeting, October 10-14, 2025, San Antonio, TX