ArticleThe Annals of thoracic surgery2021
Surviving and Thriving 1 Year After Cardiac Surgery: Frailty and Delirium Matter.
Article in The Annals of thoracic surgery, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed, 29 citations in OpenAlex.
- Association Between Barthel Index and Delirium During Hospitalization in Older Patients with Acute Decompensated Heart Failure.Journal of cardiovascular development and disease · 2026Article
- Characteristics of Hospitalization-Associated Disability After Cardiac Surgery by Age Group.Circulation reports · 2026Article
- Knowledge mapping of frailty and surgery: a bibliometric and visualized analysis.Langenbeck's archives of surgery · 2024Article
- Impact of frailty and prefrailty on the mid-term outcomes and rehabilitation course after cardiac surgery.Surgery today · 2024Article
- Association between modified frailty index and postoperative delirium in patients after cardiac surgery: A cohort study of 2080 older adults.CNS neuroscience & therapeutics · 2024Article
- Susceptibility to acute cognitive dysfunction in aged mice is underpinned by reduced white matter integrity and microgliosis.Communications biology · 2024Article
- Functional independence, frailty and perceived quality of life in patients who developed delirium during ICU stay: a prospective cohort study.European journal of medical research · 2023Observational
- [Postoperative Delirium in Patients on Cardiopulmonary Bypass for Cardiovascular Surgeries: Incidence and Influencing Factors].Sichuan da xue xue bao. Yi xue ban = Journal of Sichuan University. Medical science edition · 2023Article
- Frailty Test Battery Development including Physical, Socio-Psychological and Cognitive Domains for Cardiovascular Disease Patients: A Preliminary Study.Journal of clinical medicine · 2022Article
- Neuroprotective effect of remote ischemic preconditioning in patients undergoing cardiac surgery: A randomized controlled trial.Frontiers in cardiovascular medicine · 2022Article
- Influences of remote ischemic preconditioning on postoperative delirium and cognitive dysfunction in adults after cardiac surgery: a meta-analysis of randomized controlled trials.Perioperative medicine (London, England) · 2021Article
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Authors and funding
9 authors at 5 institutions in 2 countries.
Funding
Abstract
backgroundWe compared 1-year functional outcomes for 4 cardiac surgery patient groups: comparison (without preoperative frailty or postoperative delirium [POD]), frailty only (with preoperative frailty only), POD only (with POD only), and frailty-POD (combined frailty and POD).
methodsConsecutive cardiac surgery patients (n = 298) at a university hospital were assessed for preoperative frailty using Fried's phenotype, and POD was assessed daily for 10 days after surgery using the Confusion Assessment Method. Functional outcomes (Barthel Index for activities of daily living [ADL]) and all-cause mortality were evaluated 1-year after surgery.
resultsPreoperative frailty presented in 85 of participants (28.5%) and POD in 38 (12.8%). Frail participants were at increased risk for POD (odds ratio = 4.9; P < .001). Overall, 1-year mortality was 4.0% (n = 12) and functional change was 0.4 ± 11.0 Barthel points. Controlling for age, cardiac risk, and baseline ADL, frailty-only and comparison participants had comparable 1-year functional outcomes. The POD-only group had greater mortality (adjusted hazard ratio = 23.9; P = .01), whereas the combined frailty-POD group had the greatest ADL decline (β = -23.7; P = .01) and the highest mortality (adjusted hazard ratio = 30.2; P = .006) compared with the comparison group.
conclusionsPreoperative frailty alone did not negatively affect cardiac surgery patients' functional outcomes up to 1 year, but coexisting frailty and POD led to substantial loss of independence on 3 to 4 ADLs and a 30.2-fold higher likelihood of dying 1 year after surgery. Because frailty led to a 4.9-fold increase in POD risk, frailty may serve as a presurgical screen to identify patients who would likely benefit from delirium prevention and functional recovery programs to maximize 1-year postsurgical outcomes.
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