Clinical Frailty Scale Assessment Before Cardiac Surgery
Document Type
Article
Publication Date
11-2025
Publication Title
Annals of Thoracic Surgery
Abstract
BACKGROUND: The Clinical Frailty Scale (CFS) is a judgement-based scoring system from 1 (very fit) to 9 (terminally ill) that is used to stratify patient frailty based on information from a clinic-based interview and assessment.
METHODS: CFS scores were assessed from patients undergoing procedures with The Society of Thoracic Surgeons risk models in a statewide collaborative database between January and September 2024. A CFS score ≥5 was considered frail. The associations between CFS scores and postoperative outcomes, existing frailty metrics, and current risk models were evaluated.
RESULTS: Of 3790 patients who underwent CFS assessment, 10.8% were frail. Frail patients were more likely to be women (12.1% vs 9.0% men) and were more likely than nonfrail patients to have chronic medical conditions, including diabetes (56% vs 43.4%) and previous stroke (18.4% vs 8.7%). Operative mortality (4.84% vs 1.79%, P < .001) and major morbidity (17.1% vs 9.5%, P < .001) were more frequent in frail patients relative to nonfrail patients. Addition of CFS to The Society of Thoracic Surgeons predicted risk of mortality model resulted in an incremental increase in C statistic (base model C statistic, 0.789; base model + CFS C statistic, 0.793).
CONCLUSIONS: The CFS is a clinic-based system that does not require specialized tools or additional testing. CFS assessment may improve preoperative risk counseling.
Recommended Citation
Pienta M, He C, Clark MJ, Fanning JS, Azoury FM, Grelecki L, et al. Clinical Frailty Scale assessment before cardiac surgery. Ann Thorac Surg. 2025. doi: 10.1016/j.athoracsur.2025.10.028. PMID: 41223914.
DOI
10.1016/j.athoracsur.2025.10.028
ISSN
1552-6259
PubMed ID
41223914