Frailty increases risk of adverse outcomes for coronary artery bypass grafting surgery
PRESS RELEASE
April 28, 2023
BOSTON , MA — Frailty is prevalent among Veterans undergoing coronary artery bypass grafting surgery and is associated with worse outcomes, according to a study by researchers at the VA Northeast Ohio and VA Boston healthcare systems published in the Journal of the American Geriatrics Society April 21, 2023.
“We know that pre-procedural frailty can negatively affect recovery and long-term benefits when undergoing major procedures like open heart surgery, but this question had not been evaluated using data from Veterans, who may have a high burden of physical and psychosocial comorbidities,” said co-first author Dr. Salil Deo, a physician researcher at VA Northeast Ohio’s Louis Stokes Cleveland VA Medical Center.
Using routinely collected data from 13,554 Veterans receiving coronary artery bypass surgery at 40 VA medical centers nationwide, the researchers observed that a large percentage were already frail or pre-frail – those at a high risk of progressing to frailty – prior to surgery. During the five years following surgery, frail and pre-frail patients were more likely to die, and experienced poorer quality of life, as well, spending fewer days at home after surgery during the first year. This negative impact was observed across all age groups.
Present options for treating patients with symptomatic stable coronary artery disease are optimizing their medical therapy, percutaneous stenting, which is minimally invasive, or bypass surgery, which is an open-heart procedure. While physicians are engaged in shared decision making with patients to decide the best individualized therapy, the systematic assessment of frailty is not always performed, especially in younger patients.
“Given the high prevalence of frailty and the adverse outcomes associated with it, we think there may be an opportunity here to improve outcomes by identifying and mitigating frailty before surgery, even in younger Veterans,” said Dr. Ariela Orkaby, senior author, associate director for research training at the New England Geriatric Research, Education and Clinical Center at VA Boston Healthcare System, and assistant professor of medicine at Harvard Medical School.
The study is available at https://agsjournals.onlinelibrary.wiley.com/doi/10.1111/jgs.18390
Winfield Danielson, Public Affairs Officer
Phone: