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Patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) obstruction who remain symptomatic despite optimal medical therapy may undergo a septal myectomy (Morrow procedure). This procedure involves excising a portion of the hypertrophied septum below the aortic valve using a heart-lung machine to improve blood flow through the LVOT. Effective preoperative and postoperative nursing management ensures successful patient outcomes, minimizes complications, and...
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Age-related pharmacokinetic changes are extensively documented, but understanding age-related pharmacodynamic alterations is relatively limited. This knowledge gap can be partly attributed to the complexity of developing appropriate measures of drug responses compared to bioanalytical methods for determining drug concentrations.Most information regarding age-related differences in human pharmacodynamics originates from cross-sectional studies. However, these studies assume that observed mean...
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During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
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Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...
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The first step in nursing management of a patient with heart failure involves thoroughly assessing the patient's medical history.Subjective Data: Obtain the patient's medical history of coronary artery disease, hypertension, myocardial infarction, and symptoms like dyspnea, orthopnea, and paroxysmal nocturnal dyspnea.Objective Data: Conduct a physical examination to identify findings such as jugular vein distention, pulmonary crackles, tachycardia, murmurs, peripheral edema, and vital signs,...
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Association of Preoperative Frailty and Postoperative Outcomes in Older Adults Undergoing Major Cardiac Procedures: A

Vetri Thangavelu1, Ojas Bhatia1, Anushka Hasija2

  • 1From the Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.

Anesthesia and Analgesia
|December 24, 2025
PubMed
Summary
This summary is machine-generated.

Frailty affects nearly 1 in 5 older adults undergoing major cardiac procedures, increasing risks for delirium, infection, and mortality. Early screening and interventions like prehabilitation can improve patient outcomes.

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Area of Science:

  • Geriatric Medicine
  • Cardiology
  • Surgical Outcomes

Background:

  • Frailty is a key risk factor for older adults undergoing major cardiac procedures.
  • Existing research has limitations due to inconsistent frailty assessment tools and limited synthesis of complications.
  • Gaps in knowledge persist regarding frailty's impact on diverse postoperative outcomes.

Purpose of the Study:

  • To determine the prevalence of preoperative frailty in older adults undergoing major cardiac procedures.
  • To assess frailty's association with various postoperative outcomes, including complications and mortality.
  • To synthesize evidence on frailty's impact using a systematic review and meta-analysis.

Main Methods:

  • Systematic review and meta-analysis adhering to PRISMA guidelines.
  • Searched MEDLINE, Embase, and Cochrane databases for relevant English-language studies.
  • Included studies using validated frailty instruments and reporting postoperative outcomes; excluded noncardiac surgeries and case reports.

Main Results:

  • Nineteen studies (n=11,667) found an overall frailty prevalence of 16.8%.
  • Frailty significantly correlated with increased odds of delirium, infection, and renal complications.
  • Frailty was associated with longer hospital and ICU stays, and higher 30-day and 1-year mortality rates.

Conclusions:

  • Frailty impacts approximately 17% of older adults undergoing major cardiac surgery.
  • Frailty is a significant predictor of adverse postoperative outcomes, including delirium, infections, renal issues, and mortality.
  • Routine frailty screening and interventions like prehabilitation are recommended to improve surgical outcomes.