Clinical Frailty Scale Assessment Before Cardiac Surgery

Area of Science:

• Geriatric Medicine
• Surgical Risk Assessment
• Health Outcomes Research

Background:

• The Clinical Frailty Scale (CFS) is a 9-point scale used to assess patient frailty through clinical interviews.
• It ranges from very fit (1) to terminally ill (9).

Purpose of the Study:

• To evaluate the association between CFS scores and postoperative outcomes.
• To assess the utility of CFS in existing frailty metrics and risk models.
• To determine if CFS improves preoperative risk stratification.

Main Methods:

• CFS scores were collected for 3790 patients undergoing procedures between January and September 2024.
• Patients with a CFS score ≥5 were classified as frail.
• Associations with postoperative outcomes, frailty metrics, and The Society of Thoracic Surgeons (STS) risk models were analyzed.

Main Results:

• 10.8% of patients were identified as frail (CFS ≥5).
• Frail patients had higher rates of operative mortality (4.84% vs. 1.79%) and major morbidity (17.1% vs. 9.5%).
• Adding CFS to the STS predicted risk of mortality model improved its predictive accuracy (C statistic increased from 0.789 to 0.793).

Conclusions:

• The CFS is a practical, clinic-based tool requiring no specialized equipment.
• CFS assessment can enhance preoperative risk counseling and patient stratification.
• Integrating CFS into risk models may lead to better surgical decision-making and patient care.