OBJECTIVE

To assess the incidence and anamnestic characteristics of frail patients with stable coronary artery disease (CAD), to evaluate the role of frailty in perioperative complications and adverse outcomes after coronary artery bypass grafting (CABG).

MATERIAL AND METHODS

The study included 387 patients admitted for elective primary CABG. A 7-item questionnaire (PRISMA-7) was used to identify frail elderly patients before the procedure. Anamnestic and laboratory data, postoperative outcomes, perioperative complications and adverse outcomes were analyzed. Statistical analysis was carried out using the IBM SPSS Statistics 26.0 software. Differences were significant at p-value <0.05.

RESULTS

Frailty was detected in 22.5% of patients with CAD before the procedure. According to anamnestic data, paraclinical and intraoperative findings, both groups (patients without frailty and frail patients) were comparable. There were differences in intraoperative and early postoperative period. Thus, postoperative rhythm disturbances (19.5 vs 10.5%, p=0.025, V=0.115, respectively) and transient ischemic attacks/ischemic strokes (5.7 vs 1.3%, p=0.031, V=0.122, respectively) were significantly more common among frail patients. There were no significant differences between both groups in the incidence of other intraoperative and early postoperative complications. In frail patients, four fatal outcomes due to early postoperative ischemia were recorded. Only one patient without frailty died (4.5 vs 0.3%, p=0.010, V=0.156, respectively).

CONCLUSION

Frailty is an independent predictor of adverse outcome in patients with coronary artery disease undergoing myocardial revascularization.