Modified predictive score based on frailty for mid-term outcomes in open total aortic arch surgery

Area of Science:

• Cardiovascular Surgery
• Geriatric Medicine
• Surgical Outcomes Research

Background:

• Surgical total aortic arch replacement (SAR) is a complex procedure with variable mid-term survival rates.
• Identifying reliable predictors of post-operative outcomes is crucial for patient management.

Purpose of the Study:

• To investigate frailty indices as novel predictors of mid-term survival following elective surgical total aortic arch replacement (SAR).

Main Methods:

• A cohort of 113 patients undergoing elective SAR were assessed for frailty using the Katz index of activities of daily living, nutritional status, skeletal muscle mass, and functional assessments.
• A scoring system was developed based on age, Canadian Study of Health and Aging (CSHA) scale, serum albumin, and Katz index to stratify patients into low-risk and high-risk groups.

Main Results:

• The developed frailty score effectively stratified patients into low-risk (0-5 points) and high-risk (6-9 points) groups.
• High-risk patients demonstrated significantly higher rates of complications, including mobility issues (47.1% vs. 11.5%) and dysphagia (41.2% vs. 13.5%).
• Three-year survival rates were substantially lower in the high-risk group (33.9%) compared to the low-risk group (96.2%).

Conclusions:

• A simple, frailty-based scoring system can accurately stratify mid-term mortality risk in patients undergoing elective surgical total aortic arch replacement.
• This risk stratification tool correlates with postoperative decline in physical function, aiding in clinical decision-making and patient counseling.