Frailty as an Independent Predictor of Adverse Outcomes in Patients Undergoing Direct Myocardial Revascularization
Abstract
1. Introduction
2. Materials and Methods
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Abbreviations
AFib | atrial fibrillation |
AFL | atrial flutter |
AH | arterial hypertension |
BMI | body mass index |
BP | blood pressure |
CABG | coronary artery bypass grafting |
CAD | coronary artery disease |
CEE | carotid endarterectomy |
CI | confidence interval |
CPB | cardiopulmonary bypass |
CRF | chronic renal failure |
DM | diabetes mellitus |
FC | functional class |
GFR | glomerular filtration rate |
HDL | high-density lipoprotein |
HF | heart failure |
ICU | intensive care unit |
MODS | multiple organ dysfunction syndrome |
MV | mechanical ventilation |
OR | odds ratio |
PAD | peripheral arteries diseases |
PCI | percutaneous coronary intervention |
PICS | postinfarction cardiac sclerosis |
RR | relative risk |
TIA | transient ischemic attack |
References
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Parameter | Patient Characteristics (n = 387) |
---|---|
Mean age, years (Me [Q1; Q3]) | 65.0 [59.0; 69.0] |
Men, n (%) | 283 (73.1) |
BMI, kg/m2 (Me [Q1; Q3]) | 29.3 [26.6; 32.1] |
Smoking, n (%) | 178 (45.9) |
Duration of CAD, years (Me [Q1; Q3]) | 2.0 [1.0; 5.0] |
FC III-IV angina, n (%) | 70 (18.1) |
PICS, n (%) | 221 (57.1) |
Atherosclerosis of the extracranial brachiocephalic arteries, n (%) | 225 (58.1) |
FC III-IV HF, n (%) | 32 (8.3) |
PCI in history, n (%) | 73 (18.9) |
TIA/Stroke in history, n (%) | 43 (11.1) |
CEE in history, n (%) | 4 (1.0) |
Ulcers, n (%) | 13 (3.4) |
AH, n (%) | 323 (83.5) |
AFL/AFib in preoperative period, n (%) | 44 (11.4) |
Pacemaker implantation in history, n (%) | 2 (0.5) |
DM II type, n (%) | 98 (25.3) |
Impaired glucose tolerance, n (%) | 74 (19.1) |
PAD, n (%) | 124 (32.0) |
CRF, n (%) | 43 (11.1) |
Bone fractures in history, n (%) | 30 (7.8) |
Femoral neck fractures in family history, n (%) | 13 (3.4) |
Rheumatoid arthritis, n (%) | 2 (0.5) |
Secondary osteoporosis, n (%) | 7 (1.8) |
Left main coronary artery stenosis, n (%) Number of diseased coronary arteries, pcs (Me [Q1; Q3]) | 86 (22.2) 2.0 [2.0; 3.0] |
Parameter | Group of Patients without Frailty, n0 = 300 (77.5%) | Group of Frail Patients, n1 = 87 (22.5%) | p (Cramer’s V) |
---|---|---|---|
Mean age, years (Me [Q1; Q3]) | 65.0 [59.0; 70.0] | 64.0 [59.5; 67.0] | 0.128 |
Men, n (%) | 209 (69.9) | 74 (84.1) | 0.008 * (0.134) |
BMI, kg/m2 (Me [Q1; Q3]) | 29.1 [26.6; 31.8] | 30.1 [26.1; 32.7] | 0.459 |
Smoking, n (%) | 130 (43.5) | 48 (54.5) | 0.067 |
Duration of CAD, years (Me [Q1; Q3]) | 2.0 [1.0; 5.0] | 4.0 [1.0; 5.5] | 0.092 |
Duration of AH, years (Me [Q1; Q3]) | 10.0 [5.0; 15.0] | 7.0 [3.0; 16.5] | 0.459 |
FC III-IV Angina, n (%) | 55 (21.1) | 11 (15.7) | 0.319 |
PICS, n (%) | 162 (54.2) | 59 (67.0) | 0.032 * (0.109) |
Atherosclerosis of the extracranial brachiocephalic arteries, n (%) | 188 (62.9) | 44 (50.0) | 0.030 * (0.110) |
III-IV HF, n (%) | 22 (8.3) | 6 (7.5) | 1.000 1 |
PCI in history, n (%) | 55 (18.3) | 22 (25.3) | 0.153 |
Stroke in history, n (%) | 30 (10.0) | 6 (6.8) | 0.412 1 |
TIA in history, n (%) | 5 (1.7) | 2 (2.3) | 0.660 1 |
CEE in history, n (%) | 3 (1.0) | 1 (1.1) | 1.000 1 |
Ulcers, n (%) | 9 (3.0) | 9 (10.2) | 0.009 1* (0.144) |
AH, n (%) | 247 (82.3) | 79 (90.8) | 0.056 |
AFib in preoperative period, n (%) | 32 (12.7) | 8 (11.6) | 1.000 1 |
AFL in preoperative period, n (%) | 4 (1.7) | 2 (2.6) | 0.636 1 |
Pacemaker implantation in history, n (%) | 1 (0.3) | 1 (1.1) | 0.404 1 |
Type II DM, n (%) | 82 (27.4) | 18 (20.5) | 0.189 |
PAD, n (%) | 87 (29.1) | 37 (42.0) | 0.022 * (0.116) |
CRF, n (%) | 41 (13.7) | 7 (8.0) | 0.161 |
Apnea, n (%) | 10 (3.3) | 1 (1.1) | 0.468 1 |
Bone fractures in history, n (%) | 17 (5.7) | 13 (14.9) | 0.010 1* (0.145) |
Femoral neck fractures in family history, n (%) | 11 (3.7) | 2 (2.3) | 0.741 1 |
Rheumatoid arthritis, n (%) | 1 (0.3) | 1 (1.1) | 0.400 1 |
Secondary osteoporosis, n (%) | 8 (2.7) | 2 (2.3) | 1.000 1 |
EuroSCORE II (Me [Q1; Q3]) | 1.6 [1.2; 2.0] | 1.4 [1.1; 1.7] | 0.063 |
Parameter | Group of Patients without Frailty, n0 = 300 (77.5%) | Group of Frail Patients, n1 = 87 (22.5%) | p |
---|---|---|---|
CPB time, min (Me [Q1; Q3]) | 76.0 [65.0; 97.0] | 77.0 [64.0; 86.5] | 0.920 |
Aortic cross-clamping, min (Me [Q1; Q3]) | 52.0 [40.0; 64.0] | 51.0 [40.0; 58.0] | 0.432 |
Number of grafts, pcs (Me [Q1; Q3]) | 2.0 [2.0; 3.0] | 2.0 [2.0; 3.0] | 0.389 |
Minimal systolic BP, mmHg (Me [Q1; Q3]) | 100.0 [92.0; 107.0] | 98.0 [96.0; 104.0] | 0.327 |
MV time, min (Me [Q1; Q3]) | 645.0 [548.0; 825.0] | 640.0 [550.5; 879.0] | 0.787 |
Blood loss on the first day after surgery, mL (Me [Q1; Q3]) | 300.0 [250.0; 400.0] | 350.0 [300.0; 500.0] | 0.092 |
ICU length of stay, hours (Me [Q1; Q3]) | 21.5 [19.5; 24.5] | 23.0 [19.0; 43.0] | 0.310 |
Outcome and Complications | Group of Patients without Frailty, n0 = 300 (77.5%) | Group of Frail Patients, n1 = 87 (22.5%) | p |
---|---|---|---|
Various complications, n (%) | 57 (19.6) | 30 (35.7) | 0.002 * (0.159) |
Death, n (%) | 1 (0.3) | 4 (4.5) | 0.010 1* (0.156) |
Myocardial infarction, n (%) | 2 (0.7) | 2 (2.3) | 0.218 1 |
Stroke, n (%) | 4 (1.3) | 5 (5.7) | 0.031 1* (0.122) |
Infectious complications, n (%) | 11 (3.7) | 6 (6.8) | 0.238 1 |
HF with extended inotropic support, n (%) | 20 (6.7) | 9 (10.2) | 0.259 1 |
Rhythm disturbances, n (%) | 31 (10.5) | 17 (19.5) | 0.025 * (0.115) |
Pleural puncture, n (%) | 5 (1.7) | – | 0.593 1 |
Sternal diastasis, n (%) | 1 (0.3) | 1 (1.1) | 0.404 1 |
MODS, n (%) | 1 (0.3) | 2 (2.3) | 0.131 1 |
Death within a year after CABG, n (%) | 2 (0.6) | 10 (11.5) | ˂0.001 1* (0.290) |
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Krivoshapova, K.; Tsygankova, D.; Bazdyrev, E.; Barbarash, O. Frailty as an Independent Predictor of Adverse Outcomes in Patients Undergoing Direct Myocardial Revascularization. Diagnostics 2024, 14, 1419. https://doi.org/10.3390/diagnostics14131419
Krivoshapova K, Tsygankova D, Bazdyrev E, Barbarash O. Frailty as an Independent Predictor of Adverse Outcomes in Patients Undergoing Direct Myocardial Revascularization. Diagnostics. 2024; 14(13):1419. https://doi.org/10.3390/diagnostics14131419
Chicago/Turabian StyleKrivoshapova, Kristina, Daria Tsygankova, Evgeny Bazdyrev, and Olga Barbarash. 2024. "Frailty as an Independent Predictor of Adverse Outcomes in Patients Undergoing Direct Myocardial Revascularization" Diagnostics 14, no. 13: 1419. https://doi.org/10.3390/diagnostics14131419
APA StyleKrivoshapova, K., Tsygankova, D., Bazdyrev, E., & Barbarash, O. (2024). Frailty as an Independent Predictor of Adverse Outcomes in Patients Undergoing Direct Myocardial Revascularization. Diagnostics, 14(13), 1419. https://doi.org/10.3390/diagnostics14131419