Frailty Is Associated With Increased Care Dependence in Patients Following Major Vascular Surgery

Area of Science:

• Vascular Surgery
• Geriatric Medicine
• Health Services Research

Background:

• Peripheral artery disease (PAD) significantly impacts patient outcomes, especially after major vascular surgery.
• Assessing frailty is crucial for predicting postoperative recovery and care needs in this vulnerable population.

Purpose of the Study:

• To evaluate the predictive capability of frailty scoring for increased care dependence and changes in living situations post-major vascular surgery in PAD patients.
• To determine if baseline frailty predicts long-term functional decline and care requirements.

Main Methods:

• Retrospective cohort study of 79 patients with PAD undergoing major vascular surgery.
• Clinical Frailty Scale (CFS) scores were assessed retrospectively at baseline, discharge, and 6 months post-discharge.
• Logistic regression analyzed the association between frailty, age, and changes in living situation.

Main Results:

• Baseline frailty significantly predicted higher frailty scores at discharge and 6 months post-surgery (p=0.001).
• Lower baseline CFS (OR 0.19) and discharge CFS (OR 34.00) predicted changes in living situation after adjusting for age.
• No significant differences in ASA classification, sex, age, or in-hospital complications were noted between frailty groups.

Conclusions:

• Frail patients with PAD undergoing major vascular surgery face a substantial risk of functional decline.
• This decline necessitates changes in living situations to accommodate increased care needs, persisting for at least 6 months post-discharge.
• Frailty assessment is vital for proactive care planning in PAD patients undergoing major vascular surgery.