Racial differences in phenotypic frailty assessment among general thoracic surgery patients.

Area of Science:

• Geriatric Medicine
• Thoracic Surgery
• Health Disparities

Background:

• Frailty assessments are recommended by the American Association for Thoracic Surgery to identify patients at increased risk of perioperative complications.
• Understanding patient factors associated with frailty is crucial for optimizing surgical outcomes in thoracic surgery.

Purpose of the Study:

• To evaluate patient factors associated with frailty in a thoracic surgery patient population.
• To identify demographic and clinical characteristics linked to frailty status.

Main Methods:

• A modified Fried's Frailty Phenotype was used for routine frailty screening in patients over 50 years old undergoing thoracic surgery evaluation.
• Chi-square and Student t-tests were used to compare demographics and comorbidities across frailty groups.
• Logistic regression models assessed associations between characteristics and frailty status (nonfrail, prefrail, frail).

Main Results:

• Out of 317 patients, 62.5% were identified as frail or prefrail.
• Frail patients were older, more likely to be single/never married, had lower income, and exhibited reduced lung function (diffusion capacity and FEV1).
• Non-Hispanic Black patients were more likely to be frail or prefrail than Non-Hispanic White patients, associated with slower gait and lower activity levels.

Conclusions:

• Non-Hispanic Black patients undergoing thoracic surgery demonstrate a higher prevalence of frailty compared to Non-Hispanic White patients.
• Differences in gait speed and physical activity contribute significantly to this observed disparity.
• Frailty assessment tools require scrutiny for potential biases that may exacerbate health disparities.