Abstract

Introduction: Fragility is characterized by vulnerability to stressors, such as cardiac surgery, and can increase the risk of postoperative complications. So, it is necessary to do a broad preoperative evaluation. This study aimed to verify the association between frailty syndrome and mortality, and other clinical outcomes, for a follow-up period of 4 years.
Methods: Cohort study, in which the patients ≥60 years old, who were submitted to cardiac surgery, were evaluated by different instruments, to detect the frailty during the pre and postoperative periods, in 4 years. Frailty was defined through the Fried Frailty Phenotype (FFF)≥3, Clinical Frailty Scale (CFS)≥4, Short Physical Performance Battery (SPPB)≤ 6, Katz Index ≥1, and abnormal values in the Gait Speed (GS) or Handgrip Strength (HGS), indexed by gender and body mass. Clinical outcomes were described and the association between frailty and mortality was verified in 4 years of follow-up.
Result: 137 patients were evaluated in the preoperative periods and 79 were included in the reevaluation 4 years after the surgery. Thirty-nine (79,6%) were men, with an average age of 72,76±5,96 years old. Among them, 49 were re-evaluated and 30 (38,0%) died in four years, whereas 20 (66,6%) died because of cardiovascular issues and 10 (33,3%) because of other noncardiac causes. Patients who were classified as fragile by FFF, CFS, SPPB, and by the GS and the isolated HGS were associated with the mortality outcome.
Conclusion: The frailty defined by different instruments is associated with long-term mortality, which reinforces the importance of using these tools in the preoperative period, to estimate the risk-benefit of the procedure.

Keywords:Frailty; Cardiac surgery; Mortality; Major adverse cardiac events