Geriatrics and Gerontology Department, Faculty of Medicine, Ain-Shams University, Egypt.
Cardiovascular and Thoracic Surgery Department, Faculty of Medicine, Ain-Shams University, Egypt.
J Alzheimers Dis. 2021;82(1):391-399. doi: 10.3233/JAD-201479.
Frailty affects up to 51%of the geriatric population in developing countries which leads to increased morbidity and mortality.
To determine the association between pre-operative frailty through multidimentional assessment score, and the incidence of post-operative complications and to validate Robinson score in geriatric Egyptian patients undergoing elective cardiac surgery.
We recruited 180 elderly participants aged 60 years old and above, who underwent elective cardiac surgery. They were divided into frail, pre-frail, and non-frail groups after application of Robinson score (which includes cognitive and functional and fall risk assessment, number of comorbidities, and different laboratory data). Type and duration of operations and the presence and severity of complications at days 3 and 7 post-surgery, and the 30-day readmission rate were assessed.
Operation duration and the occurrence of postoperative complications at days 3 and 7 were lowest in non-frail and highest in the frail group (p < 0.001 for both). Length of hospital stay and 30-day readmission rate also increased in the frail group. A positive, moderate correlation between frailty and blood transfusion (r = 0.405) and functional dependence (r = 0.552) was found at day-3 post-surgery. Finally, logistic regression analysis identified a 6-fold increase in postoperative complications in the frail group (OR = 6).
Preoperative frailty was associated with higher incidence of postoperative complications among geriatric patients undergoing elective cardiac surgery. Frailty assessment by Robinson score can be considered as an accurate tool to predict postoperative complications during preoperative assessment of elderly patients.
衰弱影响了多达 51%的发展中国家的老年人群，导致发病率和死亡率增加。
通过多维评估评分确定术前衰弱与术后并发症发生率之间的关联，并验证 Robinson 评分在埃及择期心脏手术的老年患者中的适用性。
我们招募了 180 名年龄在 60 岁及以上的老年患者，他们接受了择期心脏手术。应用 Robinson 评分（包括认知和功能以及跌倒风险评估、合并症数量和不同的实验室数据）将他们分为虚弱、衰弱前期和非衰弱组。评估手术类型和持续时间，以及术后第 3 天和第 7 天并发症的存在和严重程度，以及 30 天再入院率。
非衰弱组的手术持续时间和术后第 3 天和第 7 天并发症发生率最低，而衰弱组最高（两者均 p<0.001）。住院时间和 30 天再入院率也在衰弱组增加。术后第 3 天，衰弱与输血（r=0.405）和功能依赖（r=0.552）之间存在正相关，且相关程度为中度。最后，逻辑回归分析发现，衰弱组术后并发症的发生率增加了 6 倍（OR=6）。
择期心脏手术的老年患者术前衰弱与术后并发症发生率较高相关。通过 Robinson 评分进行衰弱评估可以被视为预测老年患者术前评估期间术后并发症的准确工具。
