{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T18:18:12Z","timestamp":1792520292521,"version":"4.5.0"},"reference-count":26,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2010,3,2]]},"abstract":"<jats:p>\n                    <jats:bold>\n                      <jats:italic>Background\u2014<\/jats:italic>\n                    <\/jats:bold>\n                    Frailty is an emerging concept in medicine yet to be explored as a risk factor in cardiac surgery. Where elderly patients are increasingly referred for cardiac surgery, the prevalence of a frail group among these is also on the rise. We assessed frailty as a risk factor for adverse outcomes after cardiac surgery.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>\n                      <jats:italic>Methods and Results\u2014<\/jats:italic>\n                    <\/jats:bold>\n                    Functional measures of frailty and clinical data were collected prospectively for all cardiac surgery patients at a single center. Frailty was defined as any impairment in activities of daily living (Katz index), ambulation, or a documented history of dementia. Of 3826 patients, 157 (4.1%) were frail. Frail patients were older, were more likely to be female, and had risk factors for adverse surgical outcomes. By logistic regression, frailty was an independent predictor of in-hospital mortality (odds ratio 1.8, 95% CI 1.1 to 3.0), as well as institutional discharge (odds ratio 6.3, 95% CI 4.2 to 9.4). Frailty was an independent predictor of reduced midterm survival (hazard ratio 1.5, 95% CI 1.1 to 2.2).\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>\n                      <jats:italic>Conclusions\u2014<\/jats:italic>\n                    <\/jats:bold>\n                    Frailty is a risk for postoperative complications and an independent predictor of in-hospital mortality, institutional discharge, and reduced midterm survival. Frailty screening improves risk assessment in cardiac surgery patients and may identify a subgroup of patients who may benefit from innovative processes of care.\n                  <\/jats:p>","DOI":"10.1161\/circulationaha.108.841437","type":"journal-article","created":{"date-parts":[[2010,2,17]],"date-time":"2010-02-17T00:10:05Z","timestamp":1266365405000},"page":"973-978","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":591,"title":["Frail Patients Are at Increased Risk for Mortality and Prolonged Institutional Care After Cardiac Surgery"],"prefix":"10.1161","volume":"121","author":[{"given":"Dana H.","family":"Lee","sequence":"first","affiliation":[{"name":"From the Division of Cardiac Surgery, Department of Surgery, Dalhousie University, Halifax, Nova Scotia, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen J.","family":"Buth","sequence":"additional","affiliation":[{"name":"From the Division of Cardiac Surgery, Department of Surgery, Dalhousie University, Halifax, Nova Scotia, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Billie-Jean","family":"Martin","sequence":"additional","affiliation":[{"name":"From the Division of Cardiac Surgery, Department of Surgery, Dalhousie University, Halifax, Nova Scotia, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra M.","family":"Yip","sequence":"additional","affiliation":[{"name":"From the Division of Cardiac Surgery, Department of Surgery, Dalhousie University, Halifax, Nova Scotia, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory M.","family":"Hirsch","sequence":"additional","affiliation":[{"name":"From the Division of Cardiac Surgery, Department of Surgery, Dalhousie University, Halifax, Nova Scotia, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_1_2","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.107.188511"},{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1994.03510260066030"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-135-10-200111200-00005"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/dji313"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-134-8-200104170-00008"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(99)00818-8"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.1041342"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.jvca.2007.08.007"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejcts.2007.01.055"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-141-6-200409210-00035"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2318-2-1"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/56.3.M146"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2005.01.062"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(98)04402-X"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.archger.2007.10.007"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1963.03060120024016"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1002\/sim.4780080504"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1093\/biomet\/68.3.589"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/26.4.315"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-130-11-199906010-00022"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2008.01671.x"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2006.00767.x"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2006.00914.x"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afl041"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.282.24.2313"},{"key":"e_1_3_2_26_2","first-page":"352","volume":"20","year":"2008","unstructured":"Brezis M, Israel S, Weinstein-Birenshtock A, Pogoda P, Sharon A, Tauber R. 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