All cognitive and physical data were gathered using a predefined questionnaire, and no interventions were administered during the study. For illiterate patients, informed consent was obtained from the patient’s legal guardian. Written informed consent was obtained from patients. Study procedures were approved by the Tehran Heart Center research ethics committee (IR.1400.005). This study aims to investigate the prognostic role of frailty in clinical complications, independence level, and cognitive impairment following CABG in frail patients compared to non-frail subjects. To the best of our knowledge, the association of frailty with cognitive dysfunction exclusively after CABG has not been widely investigated, and we aimed to investigate frailty as a predictive factor, assisting clinicians in risk stratification and preoperative counseling. The lack of sufficient evidence related to cardiac surgery outcomes and associated factors in the elderly population of Iran has been previously mentioned, highlighting the necessity of conducting relevant studies. Moreover, the role of frailty in predicting worse functional and cognitive outcomes in cardiac surgery has been previously highlighted. A recent study demonstrated that frailty was associated with an increased risk of cognitive impairment, depression, and chronic depression in patients with cardiovascular diseases. Additionally, in recent studies, Frailty has been shown to be associated with increasing mortality, length of stay in the hospital, longer intensive care unit (ICU) stay, and more discharges to intermediate care facilities in patients undergoing cardiac surgeries. Several mechanisms contribute to frailty development, such as poor nutritional support, physical dormancy, and cognitive decline, as well as comorbidities such as hypertension and diabetes mellitus. įrailty, with a prevalence ranging from 10 to 60% in cardiovascular patients, could be defined as a decrease in resilience to stressors due to insufficient physiological supply, mainly in elderly patients. Although age is an important prognostic factor and the worst clinical outcomes, such as higher mortality and pulmonary and cardiac complications, have been shown in elderly patients, selecting patients before surgery based on age may no longer be helpful as many non-elderly patients show frailty features and have less desirable hospital yields. However, while a substantial decrease trend in post-discharge and in-hospital mortality has been shown in patients undergoing CABG, a considerable major complications incidence rate of 41% has been reported in these cases, which accentuates the importance of identifying prognostic factors to identify high-risk patients. Conclusionįrailty showed a significant association with a worse preoperative independence level, cognitive function, and depression status, as well as increased postoperative complications.Ĭoronary artery bypass graft (CABG) is one of the most common cardiac surgeries in patients with severe coronary disease and myocardial ischemia, with an incidence rate of 62 per 100,000 residents in Europe and nearly 200,000 cases annually in the USA. 5.00, p = 0.051) was shown in the frail patient. A mildly significantly more extended ICU stay (6.00 vs. 19.0%), as well as a higher Euroscore (1.5 vs. A significantly higher rate of readmission (1.8% vs. 6.00, P < 0.001) was significantly lower in frail cases. According to 3-month follow-up data, postoperative MOCA and GDS scores were comparable between the two groups, while Lawton IADL (8.00 vs. Frail patients demonstrated significantly worse baseline MOCA scores (21.08 vs. Of these, 58 cases were classified as frail, and 112 individuals were non-frail, preoperatively. We included 170 patients with a median age of 66 ± 4 years (75.3% male). Outcomes between frail and non-frail groups were compared utilizing T-tests and Mann-Whitney U tests, as appropriate. The incidence of adverse outcomes was investigated at the three-month follow-up. Baseline and three-month follow-up data on frailty using the Frail scale and clinical Frail scale, functional status using the Lawton Instrumental Activities of Daily Living Scale (IADL), cognitive function by Montreal Cognitive Assessment (MoCA), and depression by the Geriatric Depression Scale (GDS) were obtained. This prospective study included patients aged over 60 years undergoing elective CABG at Tehran Heart Center from 2020 to 2022. We assessed the association between frailty and cognitive and clinical complications following CABG. Frailty is proposed as a predictor of outcomes in patients undergoing major surgeries, although data on the association of frailty and coronary artery bypass grafting (CABG) are lacking.
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