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. Author manuscript; available in PMC: 2018 Apr 1.
Published in final edited form as: Anesth Analg. 2017 Apr;124(4):1053–1060. doi: 10.1213/ANE.0000000000001560

Table 2. Important Studies Examining the Association of Frailty and Post-operative Outcomes in Cardiac Surgery and TAVI Patients.

First author, year Population Frailty Definition Outcome Finding
Cardiac Surgery (predominantly)
Lee, 201042 All cardiac surgery; Canadian; n=3826 Any deficit in ADL or ambulation, or history of dementia In-hospital and midterm mortality (median 1.8 year follow-up), discharge to an institution Baseline frailty was present in 4.1% and was independently associated with in-hospital mortality, midterm mortality, and discharge to an institution
Afilalo, 201010 CABG and/or valve, >70 y/o; 4 U.S. and Canadian centers; n=131 Gait speed (5 m) ≥6 seconds Composite of in-hospital mortality and STS morbidity Baseline frailty was present in 46% and was a predictor of the composite outcome, even after adjusting for STS risk score.
Sundermann, 201133 Elective cardiac surgery; ≥74 y/o; n=400 in cohort, but follow-up data only on n=213 Multi-item Comprehensive Assessment of Frailty score (CAF) 1-year mortality Severe frailty was present in 8.9% at baseline, and was associated with 1-year mortality, adjusted for EuroSCORE.
Afilalo, 201232 CABG and/or valve, >70 y/o; 4 U.S. and Canadian centers; n=152 4 different scales:

  1. Gait speed

  2. “Fried” criteria

  3. “Fried” criteria + cognition and mood criteria

  4. MacArthur aging scale

 Composite of in-hospital mortality and STS morbidity Depending on the scale, 20%-46% were frail. The most predictive frailty scale was 5m gait speed, which improved the model compared to STS risk score
TAVI
Green, 201245 High-risk patients with aortic stenosis and ≥60 y/o undergoing TAVI. Substudy of the PARTNER study; n=159 Gait speed, grip strength, albumin, ADL; frailty defined based on median score 1-year mortality, procedural outcomes (bleeding, vascular injury, stroke, acute kidney injury, 30-day mortality) Frailty was associated with 1-year mortality, but not with the composite of procedural outcomes.
Stortecky, 201247 ≥70 y/o undergoing TAVI; n=100 Investigator-derived, included cognition, nutrition, TUG ADL, IADL 30-day and 1-year mortality, major adverse cardiac and cerebral events Baseline frailty was present in 49% and was associated with mortality and complications, independent of STS and EuroSCORE
Schoenenberger, 201348 ≥70 y/o undergoing TAVI; n=119 Investigator-derived, included cognition, nutrition, TUG ADL, IADL, Decline in ADL ≥1 point at 6 months Baseline frailty was present in 50% and was strongly associated with functional decline

Abbreviations: TAVI—transcatheter aortic valve implantation, CABG—coronary artery bypass graft, STS-Society for Thoracic Surgeons, ADL—activities of daily living, IADL—instrumental activities of daily living, TUG—timed up and go