Impact of preoperative frailty and sarcopenia on short-term functional recovery after cardiac surgery in elderly patients: a prospective cohort study.
5 affiliations
- 1Department of Anesthesiology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, People's Republic of China; Institute of Anesthesiology, Soochow University, Suzhou, Jiangsu, People's Republic of China.
- 2Department of Intensive Care Medicine, Affiliated Hospital of Xuzhou Medical University, 99 Huaihai West Road, Xuzhou City, 221006, People's Republic of China.
- 3Department of Intensive Care Medicine, Affiliated Hospital of Xuzhou Medical University, 99 Huaihai West Road, Xuzhou City, 221006, People's Republic of China. Electronic address: [email protected].
- 4Department of Anesthesiology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, People's Republic of China; Institute of Anesthesiology, Soochow University, Suzhou, Jiangsu, People's Republic of China. Electronic address: [email protected].
- 5Department of Anesthesiology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, People's Republic of China; Institute of Anesthesiology, Soochow University, Suzhou, Jiangsu, People's Republic of China. Electronic address: [email protected].
Abstract
Background
Preoperative sarcopenia and frailty are associated with poor outcomes in elderly patients undergoing cardiac surgery; this study aimed to investigate the effects of sarcopenia and frailty on postoperative recovery in elderly patients.Methods
This prospective cohort study included 566 patients aged ≥60 years with an American Society of Anaesthesiologists (ASA) II-IV status who were scheduled for elective open-heart surgery between June 30, 2024, and April 5, 2026. Frailty was assessed using the Comprehensive Geriatric Assessment Frailty Index (CGA-FI). Sarcopenia was diagnosed based on the CT-based skeletal muscle index (SMI), grip strength, and physical function. The primary outcome was worsening disability or death within 3 months after surgery.A multivariate logistic regression model was used to estimate the association of sarcopenia and/or frailty with worsening disability or death within 3 months after surgery.Results
Patients with sarcopenia and frailty did not experience a reduction in disability burden within 3 months postoperatively [-2.0 (IQR: -9.0, 21.2)]. In contrast, patients with sarcopenia only and those with frailty only had significant reductions in the overall disability burden [-5.0 (IQR: -7.0, 0.0) and -5.0 (IQR: -8.0, -1.0)]. Compared with normal patients, those with both sarcopenia and frailty (OR = 3.09; 95% CI 1.61-5.96), those with sarcopenia only (OR = 2.65; 95% CI 1.38-5.12), and those with frailty only (OR 1.93; 95% CI 1.01-3.72) had a significantly increased risk of worsening disability or death within 3 months post-surgery.Conclusion
Frailty, sarcopenia, and their combination are associated with a significantly increased risk of worsening disability or death within 3 months after surgery. Notably, compared with patients with both sarcopenia and frailty, those with frailty alone or sarcopenia alone have a lower burden of postoperative disability.
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BibTeX
@article{fan2026impact,
title = {{Impact of preoperative frailty and sarcopenia on short-term functional recovery after cardiac surgery in elderly patients: a prospective cohort study.}},
author = {Guanglei Fan and Yang Zhang and Guoqiang Chen and Wanzhou Wang and Wenjing Zhao and Xiaowen Meng and Fuhai Ji},
journal = {The journal of nutrition, health \& aging},
year = {2026},
month = oct,
doi = {10.1016/j.jnha.2026.101003},
url = {https://europepmc.org/article/MED/42854514},
note = {CC BY},
}
RIS
TY - JOUR
TI - Impact of preoperative frailty and sarcopenia on short-term functional recovery after cardiac surgery in elderly patients: a prospective cohort study.
AU - Guanglei Fan
AU - Yang Zhang
AU - Guoqiang Chen
AU - Wanzhou Wang
AU - Wenjing Zhao
AU - Xiaowen Meng
AU - Fuhai Ji
PY - 2026
DA - 2026/10/09
JO - The journal of nutrition, health & aging
DO - 10.1016/j.jnha.2026.101003
UR - https://europepmc.org/article/MED/42854514
AB - Background Preoperative sarcopenia and frailty are associated with poor outcomes in elderly patients undergoing cardiac surgery; this study aimed to investigate the effects of sarcopenia and frailty on postoperative recovery in elderly patients.Methods This prospective cohort study included 566 patients aged ≥60 years with an American Society of Anaesthesiologists (ASA) II-IV status who were scheduled for elective open-heart surgery between June 30, 2024, and April 5, 2026. Frailty was assessed using the Comprehensive Geriatric Assessment Frailty Index (CGA-FI). Sarcopenia was diagnosed based on the CT-based skeletal muscle index (SMI), grip strength, and physical function. The primary outcome was worsening disability or death within 3 months after surgery.A multivariate logistic regression model was used to estimate the association of sarcopenia and/or frailty with worsening disability or death within 3 months after surgery.Results Patients with sarcopenia and frailty did not experience a reduction in disability burden within 3 months postoperatively [-2.0 (IQR: -9.0, 21.2)]. In contrast, patients with sarcopenia only and those with frailty only had significant reductions in the overall disability burden [-5.0 (IQR: -7.0, 0.0) and -5.0 (IQR: -8.0, -1.0)]. Compared with normal patients, those with both sarcopenia and frailty (OR = 3.09; 95% CI 1.61-5.96), those with sarcopenia only (OR = 2.65; 95% CI 1.38-5.12), and those with frailty only (OR 1.93; 95% CI 1.01-3.72) had a significantly increased risk of worsening disability or death within 3 months post-surgery.Conclusion Frailty, sarcopenia, and their combination are associated with a significantly increased risk of worsening disability or death within 3 months after surgery. Notably, compared with patients with both sarcopenia and frailty, those with frailty alone or sarcopenia alone have a lower burden of postoperative disability.
SN - 1760-4788
ER -