Understanding the Association Between Frailty and Cardiac Surgical Outcomes

Background Previous work identified a direct relationship between frailty and adverse outcomes in cardiac surgery, but assessment of the effect across subgroups of patients has largely been ignored. This study identified whether the association of frailty (measured by gait speed) with adverse outcomes differed across subgroups of patients. Methods The study evaluated 53,932 patients who underwent cardiac operations between 2011 and 2016 across 33 Michigan institutions. Five-meter gait speed (in seconds) was divided into groups: faster ( Results Nearly one fourth (22.7%) of patients had at least one gait speed test. Slower (34% of patients) versus faster (28%) patients were older (72.5 years vs 62.6 years), had more comorbidities, and had the primary outcome (16.6% vs 9.5%) ( p p p  = 0.059) and diabetes ( p  = 0.063). Slower patients were more often discharged to a facility rather than home. Conclusions Slower gait speed was associated with increased odds of major morbidity or mortality. This effect was amplified among patients with preexisting comorbidities. Future studies should evaluate the impact of preprocedural interventions on frailty, including those aimed at addressing comorbidities.