KMID : 1812420220550030189
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Journal of Chest Surgery 2022 Volume.55 No. 3 p.189 ~ p.196
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Association Between the Frailty Index and Clinical Outcomes after Coronary Artery Bypass Grafting
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Kim Chan-Hyeong
Kang Yoon-Jin Kim Ji-Seong Sohn Suk-Ho Hwang Ho-Young
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Abstract
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Background: This study investigated the predictive value of the frailty index calculated using laboratory data and vital signs (FI-L) in patients who underwent coronary artery bypass grafting (CABG).
Methods: This study included 508 patients (age 67.3¡¾9.7 years, male 78.0%) who underwent CABG between 2018 and 2021. The FI-L, which estimates patients¡¯ frailty based on laboratory data and vital signs, was calculated as the ratio of variables outside the normal range for 32 preoperative parameters. The primary endpoints were operative and medium- term all-cause mortality. The secondary endpoints were early postoperative complications and major adverse cardiac and cerebrovascular events (MACCEs).
Results: The mean FI-L was 20.9%¡¾10.9%. The early mortality rate was 1.6% (n=8). Postoperative complications were atrial fibrillation (n=148, 29.1%), respiratory complications (n=38, 7.5%), and acute kidney injury (n=15, 3.0%). The 1- and 3-year survival rates were 96.0% and 88.7%, and the 1- and 3-year cumulative incidence rates of MACCEs were 4.87% and 8.98%. In multivariable analyses, the FI-L showed statistically significant associations with medium-term all-cause mortality (hazard ratio [HR], 1.042; 95% confidence interval [CI], 1.010?1.076), MACCEs (subdistribution HR, 1.054; 95% CI, 1.030?1.078), atrial fibrillation (odds ratio [OR], 1.02; 95% CI, 1.002?1.039), acute kidney injury (OR, 1.06; 95% CI, 1.014?1.108), and re-operation for bleeding (OR, 1.09; 95% CI, 1.032?1.152). The minimal p-value approach showed that 32% was the best cutoff for the FI-L as a predictor of all-cause mortality post-CABG.
Conclusion: The FI-L was a significant prognostic factor related to all-cause mortality and postoperative complications in patients who underwent CABG.
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KEYWORD
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Risk assessment, Coronary artery bypass, Frailty
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