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Frail patients are at increased risk for mortality and prolonged institutional care after cardiac surgery
Lee DH, Buth KJ, Martin BJ, Yip AM, Hirsch GM.. Circulation, 2010-02-16
Topic: Risk, prevention and care in population studies
Background Frailty is an emerging concept in medicine yet to be explored as a risk factor in cardiac surgery. Where elderly patients are increasingly referred for cardiac surgery, the prevalence of a frail group among these is also on the rise. We assessed frailty as a risk factor for adverse outcomes after cardiac surgery. Methods and results Functional measures of frailty and clinical data were collected prospectively for all cardiac surgery patients at a single center. Frailty was defined as any impairment in activities of daily living (Katz index), ambulation, or a documented history of dementia. Of 3826 patients, 157 (4.1%) were frail. Frail patients were older, were more likely to be female, and had risk factors for adverse surgical outcomes. By logistic regression, frailty was an independent predictor of in-hospital mortality (odds ratio 1.8, 95% CI 1.1 to 3.0), as well as institutional discharge (odds ratio 6.3, 95% CI 4.2 to 9.4). Frailty was an independent predictor of reduced midterm survival (hazard ratio 1.5, 95% CI 1.1 to 2.2). Conclusions Frailty is a risk for postoperative complications and an independent predictor of in-hospital mortality, institutional discharge, and reduced midterm survival. Frailty screening improves risk assessment in cardiac surgery patients and may identify a subgroup of patients who may benefit from innovative processes of care.
Key findings
- Methods and results Functional measures of frailty and clinical data were collected prospectively for all cardiac surgery patients at a single center.
Why it matters
This study found that frail cardiac surgery patients, including those with a documented history of dementia, had higher risks of in-hospital death, institutional discharge, and reduced midterm survival. It is about surgical outcomes in frail patients and does not test any treatment, cure, or prevention for Alzheimer's disease.
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Study details
- Participants3,826
- Effect size4.1%
- Evidence strengthLow
How this study scored 54/100
Published in a peer-reviewed journal. Scored zero for study design and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Circulation) |
| Journal's citation record | 4 / 4 | Circulation: journal h-index 848 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2010 — within 20 year(s) of the newest study here |
| Sample size | 3 / 4 | 3,826 participants |
| Effect reported | 2 / 3 | Effect reported as a number, without an interval or test |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 6 / 7 | Cited 682 times (OpenAlex, 2026-10-10) |
| Citations per year | 4 / 5 | 37.9 citations a year over 18 year(s) since 2010 |
| Impact for its field and year | 4 / 6 | Cited 12.3× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 1 / 6 | Cited by 1 other studies in this library |
| Still being cited | 3 / 4 | Cited 69 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 2 / 4 | Last-listed author Gregory M. Hirsch: h-index 34 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | Dalhousie University: institution h-index 778 (OpenAlex) |
| Multi-centre collaboration | 0 / 3 | OpenAlex lists 1 institution(s) in 1 country — scores zero (affiliation lists can be incomplete) |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 20159833) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 54 / 100 | — |
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Read the original
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Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
APA 7th
Lee, D. H., Buth, K. J., Martin, B. J., Yip, A. M., & Hirsch, G. M. (2010). Frail patients are at increased risk for mortality and prolonged institutional care after cardiac surgery. Circulation. https://doi.org/10.1161/circulationaha.108.841437
Vancouver
Lee DH, Buth KJ, Martin BJ, Yip AM, Hirsch GM. Frail patients are at increased risk for mortality and prolonged institutional care after cardiac surgery. Circulation. 2010. doi:10.1161/circulationaha.108.841437. PMID: 20159833.
BibTeX
@article{lee2010-20159833,
author = {Lee, D. H. and Buth, K. J. and Martin, B. J. and Yip, A. M. and Hirsch, G. M.},
title = {{Frail patients are at increased risk for mortality and prolonged institutional care after cardiac surgery}},
journal = {Circulation},
year = {2010},
doi = {10.1161/circulationaha.108.841437},
pmid = {20159833},
url = {https://doi.org/10.1161/circulationaha.108.841437}
}
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