Association Between Preoperative Frailty and Postoperative Pulmonary Complications Among Elderly Patients Undergoing Cardiac Surgery:a Prospective Cohort Study
10.3969/j.issn.1000-3614.2025.06.006
- VernacularTitle:术前衰弱与老年心外科患者术后肺部并发症相关性的前瞻性队列研究
- Author:
Bomiao LIU
1
;
Xue FENG
1
;
Ruoxi LI
1
;
Ya SONG
1
;
Tingting DOU
1
Author Information
1. 中国医学科学院 北京协和医学院 国家心血管病中心 阜外医院 心脏康复中心,北京 100037
- Publication Type:Journal Article
- Keywords:
elderly;
cardiac surgery;
frailty;
pulmonary complication
- From:
Chinese Circulation Journal
2025;40(6):591-596
- CountryChina
- Language:Chinese
-
Abstract:
Objectives:To explore the correlation between preoperative frailty and postoperative pulmonary complications in elderly patients undergoing cardiac surgery,and to provide a scientific basis for the comprehensive perioperative management of these patients.Methods:In this prospective cohort study,elderly patients(≥60 years old)who were scheduled to undergo coronary artery bypass grafting(CABG)and/or heart valve surgery at Fuwai Hospital,Chinese Academy of Medical Sciences from December 2022 to December 2023 were consecutively enrolled.Patients were divided into the postoperative pulmonary complication group and the non-postoperative pulmonary complication group based on whether they developed postoperative pulmonary complications.Demographic data,preoperative frailty status,physical function indicators(6-meter walking speed,pulmonary function),laboratory test indicators,and surgical data of the two groups were collected and compared.Multivariate logistic regression analysis was used to evaluate the correlation between preoperative frailty and postoperative pulmonary complications in these patients.Results:A total of 522 patients were included in the study,66(12.6%)had preoperative frailty.There were 159 cases(30.5%)in the postoperative pulmonary complication group and 363 cases(69.5%)in the non-postoperative pulmonary complication group.Compared with the non-postoperative pulmonary complication group,the postoperative pulmonary complication group had a higher prevalence of preoperative frailty,cerebral infarction,and pulmonary hypertension,lower maximal inspiratory pressure,slower 6-meter walking speed,a higher proportion of patients undergoing heart valve surgery and CABG+heart valve surgery,and significantly longer mechanical ventilation time,intensive care unit stay,and postoperative hospital stay(all P<0.05).Multivariate logistic regression analysis showed that preoperative frailty(OR=1.998,95%CI:1.005-3.973,P=0.048),maximal inspiratory pressure(OR=0.987,95%CI:0.977-0.997,P=0.011),6-meter walking speed(OR=0.003,95%CI:0.001-0.017,P<0.001),mechanical ventilation time(OR=2.295,95%CI:1.601-3.290,P<0.001),and CABG+heart valve surgery(OR=1.772,95%CI:1.294-2.428,P<0.001)were independent risk factors of postoperative pulmonary complications in elderly patients undergoing cardiac surgery.Conclusions:Preoperative frailty increases the risk of postoperative pulmonary complications in elderly patients undergoing cardiac surgery.
