Baseline characteristics of patients aged 50 years and older referred for nonemergent cardiac surgery, stratified by CFS score*
| Characteristic | No. (%) of patients† | p value | ||
|---|---|---|---|---|
| Overall n = 529 | CFS ≥ 5 n = 51 | CFS ≤ 4 n = 478 | ||
| CFS score presurgery, median (IQR) | 3 (3–4) | 5 (5–6) | 3 (5–6) | < 0.001 |
| Sex, female | 137 (25.9) | 26 (51.0) | 111 (23.2) | < 0.001 |
| Age, yr | ||||
| Median (IQR) | 67 (60–74) | 75 (65–80) | 67 (60–73) | < 0.001 |
| < 60 | 124 (23.4) | 7 (13.7) | 117 (24.5) | 0.08 |
| 60–69 | 198 (37.4) | 10 (19.6) | 188 (39.3) | 0.01 |
| 70–79 | 154 (29.1) | 19 (37.3) | 135 (28.2) | 0.2 |
| 80–89 | 53 (10.0) | 15 (29.4) | 38 (7.9) | < 0.001 |
| Employed or volunteer‡ | 242 (45.7) | 9 (17.6) | 233 (48.7) | < 0.001 |
| Living at home independently (no help) | 240 (45.4) | 17 (33.3) | 223 (46.7) | 0.07 |
| Postsecondary education | 290 (55.8) | 35 (71.4) | 255 (54.1) | 0.02 |
| Married or common-law | 418 (79.0) | 38 (74.5) | 380 (79.5) | 0.4 |
| EuroSCORE II, mean ± SD | 5 ± 3 | 8 ± 3 | 5 ± 3 | < 0.001 |
| Parsonnet Score, mean ± SD | 14 ± 8 | 22 ± 10 | 13 ± 8 | < 0.001 |
| Charlson Comorbidity Index score, median (IQR) | 1 (0–3) | 2 (0–4) | 1 (0–3) | 0.04 |
| Timed Up and Go Test, s, median (IQR) | 10 (8–12) | 18 (11–27) | 9 (8–12) | < 0.001 |
| Timed Up and Go Test, ≤ 19 s | 469 (91.4) | 24 (55.8) | 445 (94.7) | < 0.001 |
| Surgery type | ||||
| Isolated CABG | 202 (38.2) | 11 (21.6) | 191 (40.0) | 0.01 |
| Isolated valve (any valve) | 219 (41.4) | 24 (47.1) | 195 (40.8) | 0.4 |
| Combined CABG and valve | 91 (17.2) | 15 (29.4) | 76 (15.9) | 0.02 |
| Myomectomy, ASD or myxoma | 9 (1.7) | 0 (0) | 9 (1.9) | – |
| Isolated proximal aorta | 8 (1.5) | 1 (2.0) | 7 (1.5) | 0.8 |
| Presurgical conditions — cardiac | ||||
| Congestive heart failure | 80 (15.1) | 17 (33.3) | 63 (13.2) | < 0.001 |
| Peripheral vascular disease | 58 (11.0) | 10 (19.6) | 48 (10.0) | 0.04 |
| Pacemaker or AICD | 18 (3.4) | 6 (11.8) | 12 (2.5) | 0.001 |
| Aortic valve stenosis | 227 (42.9) | 31 (60.8) | 196 (41.0) | 0.01 |
| Previous cardiac surgery | 32 (6.0) | 3 (5.9) | 29 (6.1) | > 0.9 |
| Pulmonary arterial hypertension | 47 (8.9) | 11 (21.6) | 36 (7.5) | 0.001 |
| Presurgical conditions — noncardiac | ||||
| Peptic ulcer disease | 30 (5.7) | 5 (9.8) | 25 (5.2) | 0.2 |
| Malignant disease | 68 (12.9) | 13 (25.5) | 55 (11.5) | 0.01 |
| Rheumatoid arthritis | 81 (15.3) | 19 (37.3) | 62 (13.0) | < 0.001 |
| Neurologic dysfunction§ | 85 (16.1) | 16 (31.4) | 69 (14.4) | 0.002 |
| Creatinine level, presurgery, μmol/L, mean ± SD | 91 ± 47 | 97 ± 39 | 91 ± 48 | 0.2 |
| Chronic kidney disease¶ | 6 (1.1) | 2 (3.9) | 4 (0.8) | 0.1 |
| BMI, mean ± SD | 30 ± 6 | 31 ± 6 | 30 ± 6 | 0.4 |
| BMI < 19 or > 29 | 232 (43.9) | 25 (49.0) | 207 (43.3) | 0.4 |
| History of falls | 69 (13.1) | 17 (34.7) | 52 (10.9) | < 0.001 |
| Memory loss | 146 (27.6) | 20 (39.2) | 126 (26.4) | 0.05 |
| Previous 12-month hospitalizations | 128 (24.6) | 22 (44.9) | 106 (22.5) | 0.001 |
| Prescribed medications, median (IQR) | 5 (3–7) | 6 (4–10) | 5 (3–7) | < 0.001 |
| Taking ≥ 5 prescribed medications | 292 (55.2) | 36 (70.6) | 256 (53.6) | 0.02 |
| Perioperative course | ||||
| Aorta cross-clamp, min, median (IQR) | 86 (62–114) | 89 (71–118) | 86 (60–113) | 0.4 |
| Cardiopulmonary bypass, min, median (IQR) | 109 (83–144) | 111 (90–162) | 109 (82–143) | 0.4 |
Note: AICD = automatic implantable cardioverter-defibrillator, ASD = atrial septal defect, BMI = body mass index, CABG = coronary artery bypass grafting, CFS = Clinical Frailty Scale, IQR = interquartile range, SD = standard deviation.
↵* Missing data: CFS scores (n = 2; imputed); postsecondary education (n = 9); Timed Up & Go Test (n = 16); history of falls (n = 3); previous 12-month hospitalization (n = 8).
↵† Unless stated otherwise.
↵‡ Patients reported their full-time employment and/or volunteer status.
↵§ Neurologic dysfunction: disease severely affecting ambulation or day-to-day functioning.
↵¶ Chronic kidney disease: history of diabetic nephropathy, mild renal failure, uremic syndrome, receiving dialysis, episodes of acute renal failure, kidney transplant or serum creatinine > 265 μmol/L.