Frailty Assessment and Perioperative Major Adverse Cardiovascular Events After Noncardiac Surgery - 21/03/23
Abstract |
Objective |
Frailty is an emerging risk factor for adverse outcomes. However, perioperative frailty assessments derived from electronic health records have not been studied on a large scale. We aim to estimate the prevalence of frailty and the associated incidence of major adverse cardiovascular events (MACE) among adults hospitalized for noncardiac surgery.
Methods |
Adults aged ≥45 years hospitalized for noncardiac surgery from 2004-2014 were identified from the National Inpatient Sample. The validated Hospital Frailty Risk Score (HFRS) derived from International Classification of Diseases codes was used to classify patients as low (HFRS <5), medium (5-10), or high (>10) frailty risk. The primary outcome was MACE, defined as myocardial infarction, cardiac arrest, and in-hospital mortality. Multivariable logistic regression was used to estimate the adjusted odds of MACE stratified by age and HFRS.
Results |
A total of 55,349,978 hospitalizations were identified, of which 81.0%, 14.4%, and 4.6% had low, medium, and high HFRS, respectively. Patients with higher HFRS had more cardiovascular risk factors and comorbidities. MACE occurred during 2.5% of surgical hospitalizations and was common among patients with high frailty scores (high HFRS: 9.1%, medium: 6.9%, low: 1.3%, P < .001). Medium (adjusted odds ratio [aOR] 2.05; 95% confidence interval [CI], 2.02-2.08) and high (aOR 2.75; 95% CI, 2.70-2.79) HFRS were associated with greater odds of MACE vs low HFRS, with the greatest odds of MACE observed in younger individuals 45-64 years (interaction P value < .001).
Conclusions |
The HFRS may identify frail surgical inpatients at risk for adverse perioperative cardiovascular outcomes.
El texto completo de este artículo está disponible en PDF.Keywords : Aging, Cardiovascular, Electronic health records, Frailty, Mortality, Surgery
Esquema
| Funding: None. |
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| Conflicts of Interest: NRS is supported, in part, by the National Heart, Lung, And Blood Institute of the National Institutes of Health under Award Number K23HL150315. |
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| Authorship: All authors have reviewed the manuscript and are in agreement about the submission for publication. ES: Methodology, formal analysis, investigation, writing – original draft, visualization; DB: Conceptualization, writing – review & editing; JSB: Conceptualization, writing – review & editing, supervision; NRS: Conceptualization, investigation, formal analysis, writing – review & editing, supervision, project administration. |
Vol 136 - N° 4
P. 372 - avril 2023 Regresar al número
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