An age-independent hospital record-based frailty score correlates with adverse outcomes after heart surgery and increased health care costsCentral MessagePerspective

Autor: Shreya Sarkar, PhD, Jeffrey B. MacLeod, BSc, Ansar Hassan, MD, PhD, Daniel J. Dutton, PhD, Keith R. Brunt, PhD, Jean-François Légaré, MD, PhD
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Zdroj: JTCVS Open, Vol 8, Iss , Pp 491-502 (2021)
Druh dokumentu: article
ISSN: 2666-2736
DOI: 10.1016/j.xjon.2021.10.018
Popis: Background: Globally, an increasing number of vulnerable or frail patients are undergoing cardiac surgery. However, large-scale frailty data are often limited by the need for time-consuming frailty assessments. This study aimed to (1) create a retrospective registry-based frailty score (FS), (2) determine its effect on outcomes and age, and (3) health care costs. Methods: Retrospective data were obtained from the New Brunswick Heart Centre registry for all cardiac surgery patients between 2012 and 2017. A 20-point FS was created using available binary risk variables. The primary outcomes of interest most relevant to vulnerable patients were prolonged hospitalization, failure to be discharged home, and hospitalization bed cost. Composite outcome of prolonged hospitalization (>8 days) and/or non-home discharge were analyzed using multivariate analysis. Results: A total of 3463 patients (mean age, 66 ± 10 years) were included in the final analysis. Tercile-based FSs were: low (0-4; n = 856), medium (5-7; n = 1709), high (≥8; n = 898). In unadjusted data, frail patients were older with more comorbidities. High FS patients had greater risks of prolonged hospitalization (median 7 vs 5 days; P 0.7% to ≤1.2% [medium], and >1.2% to 4.8% [high]; P
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