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Frailty and cardiac surgery: to operate or not?
Daniel A Emmert1, Mark J Arcario, Bruno Maranhao
1Division of Cardiothoracic Anesthesia, Department of Anesthesiology, Washington University School of Medicine, St. Louis, Missouri, USA.
Current Opinion in Anaesthesiology
|October 20, 2021
Summary
Caring for frail patients undergoing cardiac surgery is increasingly important. Frailty is linked to worse outcomes, but prehabilitation and specialized centers may improve care for this growing population.
Area of Science:
- Geriatric Medicine
- Cardiovascular Surgery
- Anesthesiology
Background:
- The aging population is leading to a rise in prefrail and frail individuals undergoing cardiac surgery.
- Anesthesiologists face challenges in optimizing care for frail cardiac surgery patients.
Purpose of the Study:
- To review the identification, management, and outcomes of frail patients in cardiac surgery.
- To discuss the implications of frailty for anesthesiology in cardiac surgery.
Main Methods:
- This is a review article.
- It synthesizes current knowledge on frailty in cardiac surgery.
Main Results:
- Frailty is associated with adverse outcomes including longer hospital stays, increased resource use, higher readmission rates, and mortality.
- Prehabilitation shows promise as a management strategy for frail cardiac surgery patients.
Conclusions:
- The increasing prevalence of frailty in cardiac surgery necessitates multicenter trials for management and treatment strategies.
- High-volume centers with expertise in managing frail patients may offer the best current approach to care.
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