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Systematic review on the predictive ability of frailty assessment measures in cardiac surgery.

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Title: Systematic review on the predictive ability of frailty assessment measures in cardiac surgery.
Authors: Abdullahi, YS
Athanasopoulos, LV
Casula, RP
Moscarelli, M
Bagnall, M
Ashrafian, H
Athanasiou, T
Item Type: Journal Article
Abstract: OBJECTIVES: Patient frailty is increasingly recognised as contributing to adverse postoperative outcomes in cardiothoracic surgery. The goal of this review is to evaluate the predictive ability of frailty scoring systems and their limitations in risk assessment of patients undergoing cardiac surgery. METHODS: Frailty studies were identified by searching electronic databases. Studies in which the measuring instrument was defined as a multidimensional tool focusing on a population undergoing cardiac operations were included. The focus was on the predictive ability of frailty in this population and a comparison with conventional risk scoring systems. Unfortunately, the lack of a significant number of studies with the same postoperative outcome precluded a formal meta-analysis. RESULTS: Of 783 studies identified in our initial search, 6 fulfilled our inclusion criteria. Frailty was identified as a predictor of mortality, morbidity and/or prolonged hospital stay in patients undergoing cardiac surgery. Our systematic review revealed the increased application of frailty scores compared to standardized risk stratification scores in cardiothoracic patients. In approximately 50% of these studies, frailty scores continued to be predictive even after adjusting for the conventional risk scoring systems. CONCLUSIONS: The assessment of frailty may enhance the preoperative workup and offer an optimized risk stratification measure in patients undergoing cardiothoracic procedures even though the reporting standards of calibration and classification measures have been relatively poor.
Issue Date: 9-Jan-2017
Date of Acceptance: 19-Sep-2016
URI: http://hdl.handle.net/10044/1/46222
DOI: https://dx.doi.org/10.1093/icvts/ivw374
ISSN: 1569-9293
Publisher: Oxford University Press (OUP)
Start Page: 619
End Page: 624
Journal / Book Title: Interactive Cardiovascular and Thoracic Surgery
Volume: 24
Issue: 4
Copyright Statement: © 2017 The Author(s). Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved. This is a pre-copy-editing, author-produced version of an article accepted for publication in Interactive Cardiovascular and Thoracic Surgery following peer review. The definitive publisher-authenticated version Yusuf S. Abdullahi, Leonidas V. Athanasopoulos, Roberto P. Casula, Marco Moscarelli, Mark Bagnall, Hutan Ashrafian, Thanos Athanasiou; Systematic review on the predictive ability of frailty assessment measures in cardiac surgery. Interact CardioVasc Thorac Surg 2017; 24 (4): 619-624. doi: 10.1093/icvts/ivw374 is available online at: https://dx.doi.org/10.1093/icvts/ivw374
Sponsor/Funder: British Heart Foundation
Funder's Grant Number: RE/08/002/23906
Keywords: Cardiac surgery
Frailty
Predictive accuracy
Review
Risk score
Respiratory System
Publication Status: Published
Conference Place: England
Appears in Collections:Department of Surgery and Cancer