- In this cohort study, the authors evaluated the association between frailty and outcomes following cardiopulmonary resuscitation (CPR) for perioperative cardiac arrest.
- This longitudinal cohort study of patients 50 years and older who were undergoing noncardiac surgery and had CPR on postoperative day 0 (i.e., intraoperatively or postoperatively on the day of surgery) used the American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP), including more than 700 participating hospitals in the US, from January 1, 2015, through December 31, 2020.
- Frailty was measured using the revised Risk Analysis Index (RAI). Frailty was defined as RAI of 40 or greater.
- Among the 3,149 patients included in the analysis, 792 patients (25.9%) had an RAI of 40 or greater, of whom 534 (67.4%) died within 30 days of surgery.
- A total of 1,793 patients (58.6%) died within 30 days after surgery with frailty compared to 1,259 patients without frailty.
- Spline regression analysis demonstrated increasing probability of mortality and nonhome discharge with increasing RAI above 37 and 36, respectively.
- According to the authors, the cohort is the largest sample ever studied to evaluate the association between frailty and CPR outcomes in any setting and is one of the largest used to describe outcomes following perioperative CPR.
- The results of this study suggest that frailty is associated with increased odds of 30-day mortality and nonhome discharge following perioperative CPR.
- Identifying patients with frailty preoperatively may inform implementation strategies to prevent cardiac arrest, guide shared decision making regarding perioperative CPR, and promote goal-concordant management of complications of surgery and anesthesia.
Summary of "Frailty and Outcomes Following Cardiopulmonary Resuscitation for Perioperative Cardiac Arrest"
Summary published August 8, 2023
