Clinical frailty scale and outcome after coronary artery bypass grafting |
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Author: | Reichart, Daniel1; Rosato, Stefano2; Nammas, Wail3; |
Organizations: |
1Hamburg University Heart Center, Hamburg, Germany 2National Center of Global Health, Istituto Superiore di Sanità, Rome, Italy 3Heart Center, Turku University Hospital, University of Turku, Turku, Finland
4Division of Cardiovascular Surgery, Verona University Hospital, Verona, Italy
5Department of Molecular Medicine and Surgery, Department of Cardiac Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden 6Department of Cardiovascular Sciences, Cardiac Surgery Unit, S. Camillo-Forlanini Hospital, Rome, Italy 7Division of Cardiac Surgery, Ospedali Riuniti, Trieste, Italy 8Department of Cardiothoracic Sciences, University of Campania, Naples, Italy 9Cardiovascular Center, Paracelsus Medical University, Nuremberg, Germany; Città di Lecce Hospital GVM Care&Research, Lecce, Italy 10Centro Clinico-Diagnostico “G.B. Morgagni”, Centro Cuore, Pedara, Italy 11Department of Cardiac Surgery, St. Anna Hospital, Catanzaro, Italy 12Division of Cardiac Surgery, University of Genoa, Genoa, Italy 13Division of Cardiac Surgery, University of Parma, Parma, Italy 14Department of Cardiac Surgery, Centro Cardiologico – Fondazione Monzino IRCCS, University of Milan, Italy 15Division of Cardiothoracic and Vascular Surgery, Pontchaillou University Hospital, Rennes, France 16Department of Surgery, Oulu University Hospital and University of Oulu, Oulu, Finland 17Department of Cardiovascular Sciences, Clinical Sciences Wing, University of Leicester, Glenfield Hospital, Leicester, UK 18Division of Cardiothoracic and Vascular Surgery, Robert Debré University Hospital, Reims, France 19Department of Thoracic and Cardio-Vascular Surgery, University Hospital Jean Minjoz, Besançon, France 20Department of Surgery, University of Turku, Turku, Finland |
Format: | article |
Version: | accepted version |
Access: | open |
Online Access: | PDF Full Text (PDF, 0.5 MB) |
Persistent link: | http://urn.fi/urn:nbn:fi-fe2019102234258 |
Language: | English |
Published: |
Oxford University Press,
2018
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Publish Date: | 2019-10-22 |
Description: |
AbstractOBJECTIVES: The aim of this study was to assess the impact of frailty on the outcome after coronary artery bypass grafting (CABG) and whether it may improve the predictive ability of European System for Cardiac Operative Risk Evaluation (EuroSCORE II). METHODS: The Clinical Frailty Scale (CFS) was assessed preoperatively in patients undergoing isolated CABG from the multicentre E-CABG registry, and patients were stratified into 3 classes: scores 1–2, scores 3–4 and scores 5–7. RESULTS: Of the 6156 patients enrolled, 39.2% had CFS scores 1–2, 57.6% scores 3–4, and 3.2% scores 5–7. Logistic regression adjusted for multiple covariates showed that the CFS was an independent predictor of hospital/30-day mortality [CFS scores 3–4, odds ratio (OR) 3.95, 95% confidence interval (CI) 2.19–7.14; CFS scores 5–7, OR 5.90, 95% CI 2.67–13.05] and resulted in an Integrated Improvement Index of 1.3 (P < 0.001) and a Net Reclassification Index of 55.6 (P < 0.001) for prediction of hospital/30-day mortality. Adding the CFS classes to EuroSCORE II resulted in an Integrated Improvement Index of 0.9 (P < 0.001) and Net Reclassification Index of 59.6 (P < 0.001) for prediction of hospital/30-day mortality with a significantly larger area under the receiver operating characteristics curve (0.809 vs 0.781, P = 0.028). The CFS was an independent predictor of mid-term mortality [CFS scores 3–4, hazard ratio (HR) 2.05, 95% CI 1.43–2.85; CFS scores 5–7, HR 3.05, 95% CI 1.83–5.06]. CONCLUSIONS: The CFS predicted early- and mid-term mortality in patients undergoing isolated CABG. Further studies are needed to evaluate whether frailty may improve the estimation of the operative risk of patients undergoing adult cardiac surgery. see all
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Series: |
European journal of cardio-thoracic surgery |
ISSN: | 1010-7940 |
ISSN-E: | 1873-734X |
ISSN-L: | 1010-7940 |
Volume: | 54 |
Issue: | 6 |
Pages: | 1102 - 1109 |
DOI: | 10.1093/ejcts/ezy222 |
OADOI: | https://oadoi.org/10.1093/ejcts/ezy222 |
Type of Publication: |
A1 Journal article – refereed |
Field of Science: |
3126 Surgery, anesthesiology, intensive care, radiology |
Subjects: | |
Copyright information: |
© The Author(s) 2018. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved. This is a pre-copyedited, author-produced version of an article accepted for publication in European Journal of Cardio-Thoracic Surgery following peer review. The version of record [insert complete citation information here] is available online at: https://doi.org/10.1093/ejcts/ezy222. |