INTRODUCTION
Frailty is currently considered as a multicausal medical syndrome that
is characterized by a diminished strength and endurance. Frailty also
implies a reduced physiological reserve, that increases an individual’s
vulnerability to develop dependency and/or death after different stress
situations (1).
This identification of frailty as an increased vulnerability of adverse
health outcomes in community-dwelling adults (2–4) led to the
characterization of frailty as an independent risk factor for mortality
and morbidity in different medical and surgical scenarios(5–7),
including cardiac surgery (8–12).
On the one hand, many studies focused on the utility of frailty to
predict adverse events after a surgical procedure (9–12). On the other
hand, more recent research has focused on the reversible nature of
frailty. In this way, it is generally considered that a decrease in the
preoperative frailty status will presumably reduce the incidence of
postoperative complications. Therefore, efforts are being made to
implement specific physical exercises and pharmacological treatments
with the aim to reduce the level of frailty during the preoperative
period (13,14). This set of preoperative measures has come to be calledprehabilitation (15–18).
Based also on this dynamic nature of frailty, it would also be
interesting to investigate the possibility of changes in frailty status
after cardiac surgery. A postoperative improvement in frailty would be
expected to the extent that the cardiac pathology was contributing to
it. We have recently published that frail patients can improve their
quality of life after surgery (19), but postoperative changes in frailty
status have not been analyzed. Besides, as a result of the surgical
aggression, a postoperative deterioration of the frailty status could
also be hypothesized, especially in vulnerable and frail patients.
However, there is scarce evidence on this issue and very few studies
have addressed it (20,21).
Therefore, the objective of this study was the analysis of the changes
of the frailty status that occur six months after a major cardiac
surgery with the use of cardiopulmonary bypass.