Assessment of the Functional Status, Frailty and Cognition in Elderly Patients Undergoing Cardiac Surgery

Background: With the population aging in the developed countries, there is an increase in the absolute number of people with manifested cardiovascular disease. A subset of these patients requires a surgical procedure on their heart valves and/or coronary arteries. Here we aimed to evaluate the usefulness of frailty assessment and geriatric scales in patients 75 years and older undergoing cardiac surgery. Methods: Sixty-eight patients from our department were referred to cardiac surgery for coronary artery bypass grafting and/or heart valve surgery. Prior to referral, they were assessed by means of activities of daily living (ADL), Mini-mental State Examination (MMSE) and Edmonton Frail Scale (EFS), as well as by Euroscore II and Society of Thoracic Surgeons (STS) scores. The incidence of perioperative complications and the length of hospital stay were recorded. Results: In the operated patients (n = 57), we identified the following parameters as contributing to the occurence of complications: arterial hypertension (perioperative arrhythmias), age and non sinus heart rhythm (neurological complications), STS score, MMSE, chronic kidney disease, time to surgery and smoking (renal complications), EFS (other complications), Euroscore II, EFS, diabetes mellitus (major complications), EFS (overall complications). Moreover, patients with a best score in ADL had a chance to have surgery without complications. Conclusion: In our study, we found that the EFS was able to predict the incidence of other, major and overall postoperative complications. In addition, patients with a maximum ADL result had a chance to undergo surgery without any complications.