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 .
Addition of Frailty and Disability to Cardiac Surgery Risk Scores Identifies Elderly Patients at High Risk of Mortality or Major Morbidity
Background — Cardiac surgery risk scores perform poorly in elderly patients , in part because they do not take into account frailty and disability which are critical determinants of health status with advanced age . There is an unmet need to combine established cardiac surgery risk scores with measures of frailty and disability to provide a more complete model for risk prediction in elderly patients undergoing cardiac surgery .  Methods and Results — This was a prospect i ve , multicenter cohort study of elderly patients ( ≥70 years ) undergoing coronary artery bypass and /or valve surgery in the United States and Canada . Four different frailty scales , 3 disability scales , and 5 cardiac surgery risk scores were measured in all patients . The primary outcome was the STS composite end point of in-hospital postoperative mortality or major morbidity . A total of 152 patients were enrolled , with a mean age of 75.9±4.4 years and 34 % women . Depending on the scale used , 20–46 % of patients were found to be frail , and 5–76 % were found to have at least 1 disability . The most predictive scale in each domain was : 5-meter gait speed ≥6 seconds as a measure of frailty ( odds ratio [ OR ] , 2.63 ; 95 % confidence interval [ CI ] , 1.17–5.90 ) , ≥3 impairments in the Nagi scale as a measure of disability ( OR , 2.98 ; 95 % CI , 1.35–6.56 ) and either the Parsonnet score ( OR , 1.08 ; 95 % CI , 1.04–1.13 ) or Society of Thoracic Surgeons Predicted Risk of Mortality or Major Morbidity ( STS-PROMM ) ( OR , 1.05 ; 95 % CI , 1.01–1.09 ) as a cardiac surgery risk score . Compared with the Parsonnet score or STS-PROMM alone , ( area under the curve , 0.68–0.72 ) , addition of frailty and disability provided incremental value and improved model discrimination ( area under the curve , 0.73–0.76 ) . Conclusions — Clinicians should use an integrative approach combining frailty , disability , and risk scores to better characterize elderly patients referred for cardiac surgery and identify those that are at increased risk
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 .