Determination of frail state and association of frailty with inflammatory markers among cardiac surgery patients in a Central European patient population

Article type: Research Article

Authors: Kiss, Rudolf^a | Farkas, Nelli^b | Jancso, Gabor^c | Kovacs, Krisztina^d | Lenard, Laszlo^{a; *}

Affiliations: [a] Heart Institute, Medical School, University of Pécs, Pécs, Hungary, and Szentágothai Research Centre, University of Pécs, Pécs, Hungary | [b] Institute of Bioanalysis, Medical School, University of Pécs, Pécs, Hungary | [c] Department of Surgical Research and Techniques, Medical School, University of Pécs, Pécs, Hungary | [d] Department of Biochemistry and Medical Chemistry, Medical School, University of Pécs, Pécs, Hungary

Correspondence: [*] Corresponding author: Laszlo Lenard, Heart Institute, University of Pécs, Medical School H-7624 Pécs, Ifjúság útja 13., Hungary. E-mail: laszlo_11_lenard@yahoo.com.

Abstract: INTRODUCTION:With the aging of the population, the screening of frail patients, especially before high-risk surgery, come to the fore. The background of the frail state is not totally clear, most likely inflammatory processes are involved in the development. METHODS:Our survey of patients over age of 65 who were on cardiac surgery were performed with Edmonton Frail Scale (EFS). Patients’ demographic, perioperative data, incidence of complications and correlations of inflammatory laboratory parameters were studied with the severity of the frail state. RESULTS:On the basis of EFS, 313 patients were divided into non-frail (NF,163,52%), pre-frail (PF,89,28.5%) and frail (F,61,19.5%) groups. Number of complications in the three groups were different (NF:0.67/patient, PF:0.76/patient, F:1.08/patient). We showed significant difference between NF and F in both intensive care and hospital stay, but there was no statistical difference between the groups in hospital deaths (NF:5/163, PF:3/89, F:5/61). We also found a significant difference between NF and F patients in preoperative fibrinogen-, CRP- and white blood cell count levels. CONCLUSIONS:We first present the incidence of frailty in patients with heart surgery in a Central-European population. According to our results, inflammatory processes are likely to play a role in the development of the frail state.

Keywords: Frailty, frail state, CRP, fibrinogen, cardiac surgery

DOI: 10.3233/CH-190681

Journal: Clinical Hemorheology and Microcirculation, vol. 76, no. 3, pp. 341-350, 2020