RESULTS Severity of frailty syndrome significantly correlated with post-surgical mortality rates and with many although not all post-surgical complications .
These relationships emerge in different type of surgical procedures and patients ' features .
BACKGROUND Frailty is a geriatric syndrome characterized by the clinical presentation of identifiable physical alterations and decreased physiological reserve .
The assessment of frailty syndrome has been recently related with post-surgical outcomes and overall mortality in older individuals .
Risk stratification in heart surgery: comparison of six score systems.
OBJECTIVE Risk scores have become an important tool in patient assessment , as age , severity of heart disease , and comorbidity in patients undergoing heart surgery have considerably increased . Various risk scores have been developed to predict mortality after heart surgery . However , there are significant differences between scores with regard to score design and the initial patient population on which score development was based . It was the purpose of our study to compare six commonly used risk scores with regard to their validity in our patient population . METHODS Between September 1 , 1998 and February 28 , 1999 , all adult patients undergoing heart surgery with cardiopulmonary bypass in our institution were preoperatively scored using the initial Parsonnet , Clevel and Clinic , French , Euro , Pons , and Ontario Province Risk ( OPR ) scores . Postoperatively , we registered 30-day mortality , use of mechanical assist devices , renal failure requiring hemodialysis or hemofiltration , stroke , myocardial infa rct ion , and duration of ventilation and intensive care stay . Score validity was assessed by calculating the area under the ROC curve . Odds ratios were calculated to investigate the predictive relevance of risk factors . RESULTS Follow-up was able to be completed in 504 prospect ively scored patients .  Receiver operating characteristics ( ROC ) curve analysis for mortality showed the best predictive value for the Euro score . Predictive values for morbidity were considerably lower than predictive values for mortality in all of the investigated score systems . For most risk factors , odds ratios for mortality were substantially different from ratios for morbidity . CONCLUSIONS Among the investigated scores , the Euro score yielded the highest predictive value in our patient population . For most risk factors , predictive values for morbidity were substantially different from predictive values for mortality . Therefore , development of specific morbidity risk scores may improve prediction of outcome and hospital cost . Due to the heterogeneity of morbidity events , future score systems may have to generate separate predictions for mortality and major morbidity events
RESULTS Severity of frailty syndrome significantly correlated with post-surgical mortality rates and with many although not all post-surgical complications .
These relationships emerge in different type of surgical procedures and patients ' features .
BACKGROUND Frailty is a geriatric syndrome characterized by the clinical presentation of identifiable physical alterations and decreased physiological reserve .
The assessment of frailty syndrome has been recently related with post-surgical outcomes and overall mortality in older individuals .