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Preoperative frailty based on laboratory data and postoperative health outcomes in patients undergoing coronary artery bypass graft surgery

 Arum Lim  ;  Mona Choi  ;  Yeonsoo Jang  ;  Hyangkyu Lee 
 HEART & LUNG, Vol.56 : 1-7, 2022-11 
Journal Title
Issue Date
Coronary Artery Bypass / adverse effects ; Frailty* / complications ; Humans ; Length of Stay ; Outcome Assessment, Health Care ; Postoperative Complications / epidemiology ; Postoperative Complications / etiology ; Retrospective Studies
30-day readmission ; Coronary artery bypass graft surgery ; Electronic hearth record ; Frailty ; Health outcome ; Length of stay
Background: Frailty is associated with adverse surgical outcomes. Patients with cardiovascular diseases have many risk factors of frailty; thus, preoperative frailty evaluation is necessary to predict adverse outcomes after coronary artery bypass graft (CABG) surgery. Laboratory data based-frailty assessments are objective and not time-consuming, addressing the need for an accurate but simple frailty screening for patients awaiting CABG surgery.

Objectives: This retrospective study aimed to determine the association between laboratory based-frailty and patient health outcomes after CABG surgery.

Methods: We evaluated 896 patients who underwent on-pump or off-pump CABG surgery between August 1, 2015 and July 31, 2020 at a tertiary hospital. The frailty index-laboratory (FI-LAB), which comprises 32 laboratory parameters and vital signs, was used for frailty assessment.

Results: The patients were divided into three groups according to their preoperative FI-LAB level as low (FI-LAB <0.25, 23.0%), moderate (FI-LAB ≥0.25 to ≤0.4, 54.9%), and high (FI-LAB>0.4, 22.1%) frailty groups. In the confounder-adjusted analysis, the lengths of hospital stay and intensive care unit stay were longer by 2.20 days (p=.023) and by 0.89 days (p=.009), respectively, in the high frailty group than those in the low frailty group. The odds ratio for 30-day readmission was also 2.58 times higher in the high frailty group than that in the low frailty group.

Conclusion: A high preoperative FI-LAB score indicates increasing risks of adverse postoperative outcomes among CABG surgery patients. FI-LAB has potential strengths to capture the need for a more thorough frailty assessment for cardiac surgery patients.
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3. College of Nursing (간호대학) > Dept. of Nursing (간호학과) > 1. Journal Papers
Yonsei Authors
Lee, Hyang Kyu(이향규) ORCID logo https://orcid.org/0000-0002-0821-6020
Jang, Yeon Soo(장연수) ORCID logo https://orcid.org/0000-0002-1898-025X
Choi, Mona(최모나) ORCID logo https://orcid.org/0000-0003-4694-0359
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