Abstract
Purpose: to assess the physiological reserve according to the Edmonton frailty scale/index (EFI) before correction of valvular heart disease (VHD) in elderly patients (≥ 60 years) and patients up to 60 years (control group).
Material and methods. Two hundred and forty patients ≥ 60 years old (mean age 69.2 ±1.3 years) and 140 patients < 60 years old (mean age 58.1 ± 2.3 years) underwent correction of valvular heart defects ± coronary heart disease (VHD ± CAD). Before surgery, the patients underwent an assessment of the physiological status according to EFI. “Not frail” were 28.3% of the elderly and 51.5% of the control group, the majority (71.7%) of the elderly and 49.0% of patients up to 60 years before surgery were from “vulnerable” to “severe frail”. Thus, the average EFI score in the elderly before operations was 7.5 ±1.9 (“vulnerable”), and in the control group it was 4.7 ±2.8 (“not frail”) (p < 0.05). Every third elderly (34.6%) and 72.1% of patients in the control group underwent correction of the defect of two valves, 7% – up to 60 years.
Results. Non-lethal complications in the early postoperative period were noted in 42.9% of the elderly and in 20% of patients in the control group. Hospital mortality in ≥ 60 years is 7.9%, in up to 60 years is 3.6%. Predictors of postoperative complications in the elderly was EFI-status “mid, frail” → “severe frail” (p = 0.04), and in <60 years – “mid, frail” (p = 0.05).
Conclusion. A low physiological reserve (“painful” → “severe frail”) became a predictor of the development of complications in the early postoperative period in the elderly patients and in patients up to 60 years of age.
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About the authors
- Tat’yana G. Nikitina, Dr. Med. Sci., Professor, Head of the Department; ORCID
- Dmitriy M. Pelekh, Cand. Med. Sci., Researcher, Cardiologist; ORCID
- Knar S. Gulyan, Cand. Med. Sci., Researcher, Cardiologist; ORCID
- Tat’yana Yu. Filippkina, Cand. Phys. Math. Sci., Analyst; ORCID
- Elena Z. Golukhova, Dr. Med. Sci., Professor, Academician of the Russian Academy of Sciences, Director of Center; ORCID
