Different approaches of preoperative frailty as a risk factor for long-term mortality in elective cardiac and vascular surgery
Szabó András
Theoretical and Translational Medicine
Dr. Kellermayer Miklós
Sebészeti, Transzplantációs és Gasztroenterológiai Klinika, Dollinger terem
2024-03-27 14:00:00
Cardiovascular Disorders: Physiology and Medicine of Ischaemic Circulatory Diseases
Dr. Merkely Béla
Dr. Székely Andrea
Dr. Babik Barna
Dr. Fülöp András
Dr. Szijártó Attila
Dr. Varga János
Dr. Csomós Ákos
The purpose of my research work was to investigate risk factors in preoperative settings. Among vascular and cardiac surgical patients, various factors were examined and evaluated as potential risk factors for mortality. During the process, the focus was on those factors that had not received much interest at the time in the perioperative routine risk assessment. These factors are related to frailty syndrome, which is a lesser-known clinical condition that is associated with postprocedural mortality, morbidity, and quality of life.
During my research work that is summarized in this thesis, the effect of mild cognitive impairment on long-term mortality was identified in the vascular surgical patient cohort. The Mini Mental State Examination with modified cut-off values can be used detect clinically significant cognitive dysfunction. Preoperative chronic opioid derivative administration could also be a predictor of long-term mortality in these patients. Chronic opioid use is related to a higher rate of depression, anxiety, and loss of cognitive performance.
The comprehensive frailty approach showed a useful method to estimate cardiac and vascular surgical patients’ preoperative frailty status. For this purpose, a multidomain frailty index was created using widespread indicators for different aspects. However, comprehensive frailty mapping could be a time-consuming process, and its usefulness for estimating long-term mortality was proven in our cohort.
Our findings could be useful during preprocedural risk stratification, thereby making risk assessment more precise. A more accurate estimation can help to identify patients who need rehabilitation. Furthermore, this precision can lead to correct choices regarding the optimal treatment for our patients, especially in difficult cases.
