Frailty Tied to Worse Outcomes After Perioperative Cardiac Arrest

FRIDAY, July 7, 2023 (HealthDay News) -- Patients with higher frailty burden are at increased risk of mortality and nonhome discharge after perioperative cardiac arrest, according to a study published online July 3 in JAMA Network Open.

Matthew B. Allen, M.D., from Harvard Medical School in Boston, and colleagues examined the association between frailty and outcomes following cardiopulmonary resuscitation (CPR) for perioperative cardiac arrest. Analysis included 3,149 patients (≥50 years) undergoing noncardiac surgery (2015 through 2020) who received CPR on postoperative day 0.

The researchers found that when adjusting for race, American Society of Anesthesiologists physical status, sepsis, and emergency surgery, there was a positive association between frailty and mortality (adjusted odds ratio [aOR], 1.35; 95 percent confidence interval [CI], 1.11 to 1.65; P = 0.003). There was a steadily increasing probability of mortality and nonhome discharge with increasing Risk Analysis Index (RAI) >37 and 36, respectively. The association between frailty and mortality after CPR varied by procedure urgency (aOR for nonemergent procedures, 1.55 [95 percent CI, 1.23 to 1.97] versus aOR for emergent procedures, 0.97 [95 percent CI, 0.68 to 1.37]; P = 0.03 for interaction). There was increased odds of nonhome discharge noted for an RAI of ≥40 versus <40 (aOR, 1.85; 95 percent CI, 1.31 to 2.62; P < 0.001).

"Identifying patients who are undergoing surgery and have frailty may inform primary prevention strategies, guide shared decision-making regarding perioperative CPR, and promote goal-concordant surgical care,” the authors write.

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