Frailty: the missing element in predicting operative mortality

Although age is an extensively documented independent risk factor for mortality, morbidity and decreased quality of life after cardiac surgery, it has also been demonstrated that excellent outcomes can be obtained after cardiac surgery in very elderly patients. The disparity between chronological and biological age that underlies these findings forms the focus of this review, which examines recent studies aiming to refine pre-operative risk stratification tools by using assessments of frailty and functional status.