The Role of Frailty in Failure to Rescue After Cardiovascular Surgery

BackgroundFailure to rescue (FTR) is gaining popularity as a quality metric. The relationship between patient frailty and FTR after cardiovascular surgery has not been fully explored. This study aimed utilize national database examine the impact of on FTR.MethodsOf 5,199,534 patients undergoing 2000 2014, 75,851 (1.5%) were identified from Nationwide Inpatient Sample frail based Johns Hopkins Adjusted Clinical Groups frailty-defining diagnoses indicator. Propensity-score matching was used adjust for patient- hospital-level characteristics comorbidities when comparing nonfrail patients.ResultsFrail average older (68 ± 12 years vs 65 years; P < .001) had more including heart failure, chronic lung, liver, or renal disease. Among 68,472 matched pairs, significantly higher rates (13.4% 11.9%; .001). contributed $39,796 increase in cost per hospitalization (P Renal respiratory pneumonia, sepsis most commonly associated with patients. When hospitals stratified by risk-adjusted mortality, low-mortality (1st quintile) centers lower costs among compared high-mortality (5th centers.ConclusionsFrailty contributes surgery. Frail can expect better outcomes at cardiac surgical excellence that adequately manage postoperative outcomes. Preoperative assessment may guide risk estimation identification who would benefit appropriate prehabilitative interventions optimize Failure FTR. Of centers. Frailty