Breaking News
December 15, 2018 - For the asking, a check is in the mail to help pay for costly drugs
December 15, 2018 - UA scientists uncover biological processes leading to rare brain disorder in babies
December 15, 2018 - The largest database on industrial poisons
December 15, 2018 - ESMO Immuno-Oncology Congress showcases novel technologies set to benefit many cancer patients
December 15, 2018 - Ovid Therapeutics Announces Plans to Move into a Phase 3 Trial in Pediatric Patients Based on End-of-Phase 2 Meeting for OV101 in Angelman Syndrome
December 15, 2018 - Left ventricular noncompaction – Genetics Home Reference
December 15, 2018 - Children’s sleep not significantly affected by screen time, new study finds
December 15, 2018 - When should dementia patients stop driving? A new guidance for clinicians
December 15, 2018 - Researchers use INTEGRA’s VIAFLO 96/384 to streamline the experimental workflow
December 15, 2018 - Researchers discover protein involved in nematode stress response
December 15, 2018 - Cancer patients have greater risk of developing shingles, study shows
December 14, 2018 - UAlberta scientists identify biomarkers for detecting Alzheimer’s disease in saliva samples
December 14, 2018 - Study uncovers link between tube travel and spread of flu-like illnesses
December 14, 2018 - Caffeine plus another compound in coffee may fight Parkinson’s disease
December 14, 2018 - GW researchers review studies on treatments for prurigo nodularis
December 14, 2018 - Lack of peds preventive care ups unplanned hospital admissions
December 14, 2018 - Miscarriage: When Language Deepens Pain
December 14, 2018 - New method helps better understand pathological development of ALS
December 14, 2018 - Intellectually active lifestyle confers protection against neurodegeneration in Huntington’s patients
December 14, 2018 - Mammalian collagen nanofibrils become stronger and tougher with exercise
December 14, 2018 - Considerable Morbidity, Mortality Due to Animal Encounters
December 14, 2018 - Researchers find inhibiting one protein destroys toxic clumps seen in Parkinson’s disease
December 14, 2018 - How early physical therapy can lessen the long-term need for opioids
December 14, 2018 - Depression, suicide rates highest in Mountain West states
December 14, 2018 - New model could cure the potential to underestimate how quickly diseases spread
December 14, 2018 - Exercise-induced hormone activates cells critical for bone remodeling in mice
December 14, 2018 - Researchers discover new mechanism behind spread of malignant pleural mesothelioma
December 14, 2018 - Health Tip: Celebrate a Healthier Holiday
December 14, 2018 - Scalpel-free surgery enhances quality of life for Parkinson’s patients, study finds
December 14, 2018 - Early physical therapy can reduce risk, amount of long-term opioid use | News Center
December 14, 2018 - Genetic marker, predictor of early relapse in common childhood cancer discovered
December 14, 2018 - Study could lead to a potential new way of treating sepsis
December 14, 2018 - New protein complex helps embryonic stem cells to maintain their indefinite potential
December 14, 2018 - Salk professor receives $1.8 million from NOMIS Foundation for research on mechanisms to promote health
December 14, 2018 - New discovery will improve the safety and predictability of CRISPR
December 14, 2018 - Geneticists discover how sex-linked disorders arise
December 14, 2018 - New method to visualize small-molecule interactions inside cells
December 14, 2018 - Study describes mechanism that makes people more vulnerable to hunger-causing stimuli
December 14, 2018 - Chronic opioid therapy associated with increased healthcare spending and hospital stays
December 14, 2018 - Blood Types
December 14, 2018 - Obesity linked to increased risk of early-onset colorectal cancer
December 14, 2018 - Blood test helps identify distinct molecular signatures in children with cystic fibrosis
December 14, 2018 - Scientists use water to track electrical activity of nerve cells
December 14, 2018 - Recurrence of urinary tract infection may depend on bacterial strain, study shows
December 14, 2018 - GBT Announces U.S. FDA Agrees with its Proposal Relating to Accelerated Approval Pathway for Voxelotor for the Treatment of Sickle Cell Disease and GBT Plans to Submit New Drug Application (NDA)
December 14, 2018 - Partial Thromboplastin Time (PTT) Test: MedlinePlus Lab Test Information
December 14, 2018 - Common tactics for health promotion at work may be detrimental to employees with obesity
December 14, 2018 - Myths about migration and health not supported by available evidence
December 14, 2018 - Recent findings on rare genetic disorder may help develop new treatment options
December 14, 2018 - New drug shows promise in treating sarcomas
December 14, 2018 - Scientists perform lung lavage as new approach for tuberculosis diagnosis in rhinoceros
December 14, 2018 - Answering the Biggest Neurological Research Questions of Today
December 14, 2018 - Recent winners of the Nobel Medicine Prize
December 14, 2018 - KHN’s ‘What the Health?’ Insurance enrollment is lagging — and there are lots of reasons why
December 14, 2018 - Study assesses safety and efficacy of new treatment for pancreatic cancer
December 14, 2018 - Weakened metabolism of immune T cells may account for serious complications in elderly
December 14, 2018 - Study finds drug targets for Ebola, Dengue, and Zika viruses
December 14, 2018 - Face masks may offer protection against staph bacteria for hog farm workers and their household members
December 14, 2018 - Shining new light on neuron firing
December 14, 2018 - Study highlights need for personalized approach to treat ICU acquired delirium
December 14, 2018 - Soot particles from road traffic significantly contribute to air pollution
December 14, 2018 - Massage helps relieve pain, improve mobility in patients with knee osteoarthritis
December 14, 2018 - Researchers explore home healthcare nurses’ knowledge attitudes toward infection control
December 14, 2018 - Average outpatient visit in the U.S. costs nearly $500, shows new study
December 14, 2018 - Reference Infliximab, Biosimilar Equivalent for Crohn’s Disease
December 14, 2018 - New contact lens to treat eye injuries
December 14, 2018 - Acne could have a genetic basis find researchers promising new cure
December 14, 2018 - Higher physical activity associated with improved mood
December 14, 2018 - New UGA study points to optimal hypertension treatment for stroke patients
December 14, 2018 - Study highlights factors that can reduce food cravings
December 14, 2018 - Researchers discover Ebola-fighting protein in human cells
December 14, 2018 - Fentanyl surpasses heroin in cause of U.S. drug overdose deaths
December 14, 2018 - When Heart Attack Strikes, Women Often Hesitate to Call for Help
December 14, 2018 - A warning about costume contacts
December 14, 2018 - Study examines link between peripheral artery disease and heart attack
December 14, 2018 - Researchers develop biotechnological tool to produce antifungal proteins in plants
December 14, 2018 - 3D-printed adaptive aids can benefit patients with arthritis
December 14, 2018 - Chronic bullying during adolescence impacts mental health
December 14, 2018 - Integral Molecular and Merus collaborate to develop bispecific antibody therapeutics
December 13, 2018 - Importance of cell cycle and cellular senescence in the placenta discovered
Frailty associated with poor survival rates in young heart patients

Frailty associated with poor survival rates in young heart patients

image_pdfDownload PDFimage_print

Traditionally, frailty is thought to be a syndrome of the elderly – one which comes as a natural and inevitable side-effect of aging, gradually transforming strong, healthy bodies into weaker, more delicate frames over time. For clinicians, frailty is a concept which has long posed formidable challenges in perioperative medicine. For patients, frailty turns even the most routine operative procedures into complicated life or death undertakings.

It is well known to science that chronological frailty, that is the degradation of the human body associated with a person’s actual age, is commonly linked to increased mortality, surgical site infections, length of hospital stay, increased healthcare expenditure and readmission rates in patients presenting for a variety of major non-cardiac surgeries. However, similar literature with regard to frailty in patients undergoing heart surgery remains scarce despite its rise in prevalence.

A new study conducted by researchers at the University of Ottawa Heart Institute and published in the Journal of the American Heart Association examines the prevalence of frailty and its association with long-term mortality in patients undergoing cardiac surgery. More specifically, the study, titled Association of Frailty and Long-Term Survival in Patients Undergoing Coronary Artery Bypass Grafting (CABG) followed patients over the age of 40 who underwent primary isolated CABG, a common surgical procedure in which one or more blocked coronary arteries are bypassed by a blood vessel graft to restore normal blood flow to the heart. Researchers examined administrative healthcare data from the Institute for Clinical Evaluative Science (ICES) and the clinical registry data from CorHealth Ontario to support their findings.

A total of 40,083 consecutive patients in Ontario who underwent isolated CABG between 2008 and 2015 were included in the study. It found the prevalence of frailty was markedly higher in patients undergoing isolated CABG, at 22%, compared to those undergoing a planned non-cardiac surgery, at just 3%, which suggests that patients undergoing cardiac surgery are a more complex population who are at higher risk of complications. Frailty was also associated with poor early and long-term survival rates – especially in patients between the ages of 40 and 74. The adjusted long-term frailty-related mortality risk was inversely proportional to age, meaning after taking other comorbidities into consideration, frailty had a higher impact on the survival of younger patients.

“To our knowledge, this is the largest cohort study to describe the long-term outcomes of frailty in patients undergoing CABG surgery,” writes the study’s principal investigator, Dr. Louise Sun, a clinician investigator and staff anesthesiologist in the Division of Cardiac Anesthesiology at the University of Ottawa Heart Institute and an adjunct ICES scientist. “Interestingly, however, our study found the presence of frailty-defining diagnoses was a stronger predictor of mortality in younger patients.”

According to the study, frailty contributed to greater differences in the survival of patients between 40 and 74 years of age and smaller differences in the long-term survival of those 85 years or older, writes Dr. Sun. “What the science is telling us is that frailty poses a higher risk of mortality in younger patients and has a lower impact on older ones.”

Researchers used the Johns Hopkins Adjusted Clinical Groups (ACG) frailty-defining diagnoses indicator to define frailty for the purpose of this study. This comprehensive tool provides a multi-dimensional snapshot of a patient’s physical status. It assesses frailty based on 10 clusters of frailty-defining diagnoses: malnutrition, dementia, impaired vision, decubitus ulcer, incontinence of urine, loss of weight, poverty, barriers to access to care, difficulty in walking, and falls.

Dr. Sun believes these recent findings highlight the importance of the concept of chronological aging versus physiological aging (a relative measure of a person’s age based on a number of physiological factors) in the prognosis of surgical patients. She says her team’s findings indicate age alone does not predict outcomes and that overall physiological health matters more.

Dr. Sun and team say there is still much to learn, and that more research will be vital for improving patient outcomes with regard to frailty in years to come.

“Frailty should be incorporated into preoperative risk stratification models to assist with optimal selection of operative candidates. Effective preoperative optimization programs such as cardiac prehabilitation, nutritional augmentation and psychosocial support may improve outcomes especially in younger patients,” she says.

Dr. Sun and her team wish to acknowledge and honour the memory of Dr. Jack Tu who passed away during the preparation of this manuscript for publication.

Source:

https://www.ottawaheart.ca/the-beat/2018/07/20/frailty-may-be-more-deadly-younger-heart-patients-study-finds

Tagged with:

About author

Related Articles