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    Association Between the Frailty Index and Clinical Outcomes after Coronary Artery Bypass Grafting

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    https://www.riss.kr/link?id=A108147219

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    다국어 초록 (Multilingual Abstract) kakao i 다국어 번역

    Background: This study investigated the predictive value of the frailty index calculated using laboratory data and vital signs (FI-L) in patients who underwent coronary artery bypass grafting (CABG).
    Methods: This study included 508 patients (age 67.3±9.7 years, male 78.0%) who underwent CABG between 2018 and 2021. The FI-L, which estimates patients’ frailty based on laboratory data and vital signs, was calculated as the ratio of variables outside the normal range for 32 preoperative parameters. The primary endpoints were operative and medium- term all-cause mortality. The secondary endpoints were early postoperative complications and major adverse cardiac and cerebrovascular events (MACCEs).
    Results: The mean FI-L was 20.9%±10.9%. The early mortality rate was 1.6% (n=8). Postoperative complications were atrial fibrillation (n=148, 29.1%), respiratory complications (n=38, 7.5%), and acute kidney injury (n=15, 3.0%). The 1- and 3-year survival rates were 96.0% and 88.7%, and the 1- and 3-year cumulative incidence rates of MACCEs were 4.87% and 8.98%. In multivariable analyses, the FI-L showed statistically significant associations with medium-term all-cause mortality (hazard ratio [HR], 1.042; 95% confidence interval [CI], 1.010–1.076), MACCEs (subdistribution HR, 1.054; 95% CI, 1.030–1.078), atrial fibrillation (odds ratio [OR], 1.02; 95% CI, 1.002–1.039), acute kidney injury (OR, 1.06; 95% CI, 1.014– 1.108), and re-operation for bleeding (OR, 1.09; 95% CI, 1.032–1.152). The minimal p-value approach showed that 32% was the best cutoff for the FI-L as a predictor of all-cause mortality post-CABG.
    Conclusion: The FI-L was a significant prognostic factor related to all-cause mortality and postoperative complications in patients who underwent CABG.
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    Background: This study investigated the predictive value of the frailty index calculated using laboratory data and vital signs (FI-L) in patients who underwent coronary artery bypass grafting (CABG). Methods: This study included 508 patients (age 67.3...

    Background: This study investigated the predictive value of the frailty index calculated using laboratory data and vital signs (FI-L) in patients who underwent coronary artery bypass grafting (CABG).
    Methods: This study included 508 patients (age 67.3±9.7 years, male 78.0%) who underwent CABG between 2018 and 2021. The FI-L, which estimates patients’ frailty based on laboratory data and vital signs, was calculated as the ratio of variables outside the normal range for 32 preoperative parameters. The primary endpoints were operative and medium- term all-cause mortality. The secondary endpoints were early postoperative complications and major adverse cardiac and cerebrovascular events (MACCEs).
    Results: The mean FI-L was 20.9%±10.9%. The early mortality rate was 1.6% (n=8). Postoperative complications were atrial fibrillation (n=148, 29.1%), respiratory complications (n=38, 7.5%), and acute kidney injury (n=15, 3.0%). The 1- and 3-year survival rates were 96.0% and 88.7%, and the 1- and 3-year cumulative incidence rates of MACCEs were 4.87% and 8.98%. In multivariable analyses, the FI-L showed statistically significant associations with medium-term all-cause mortality (hazard ratio [HR], 1.042; 95% confidence interval [CI], 1.010–1.076), MACCEs (subdistribution HR, 1.054; 95% CI, 1.030–1.078), atrial fibrillation (odds ratio [OR], 1.02; 95% CI, 1.002–1.039), acute kidney injury (OR, 1.06; 95% CI, 1.014– 1.108), and re-operation for bleeding (OR, 1.09; 95% CI, 1.032–1.152). The minimal p-value approach showed that 32% was the best cutoff for the FI-L as a predictor of all-cause mortality post-CABG.
    Conclusion: The FI-L was a significant prognostic factor related to all-cause mortality and postoperative complications in patients who underwent CABG.

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    참고문헌 (Reference)

    1 Sepehri A, "The impact of frailty on outcomes after cardiac surgery : a systematic review" 148 : 3110-3117, 2014

    2 Shahian DM, "The Society of Thoracic Surgeons 2008 cardiac surgery risk models: part 1--coronary artery bypass grafting surgery" 88 (88): S2-S22, 2009

    3 Mohr F, "TCT-43 final five-year follow-up of the SYNTAX trial : optimal revascularization strategy in patients with three-vessel disease" 60 (60): B13-, 2012

    4 Howlett SE, "Standard laboratory tests to identify older adults at increased risk of death" 12 : 171-, 2014

    5 Wu C, "Risk score for predicting long-term mortality after coronary artery bypass graft surgery" 125 : 2423-2430, 2012

    6 Sullivan PG, "Meta-analysis comparing established risk prediction models (EuroSCORE II, STS Score, and ACEF Score) for perioperative mortality during cardiac surgery" 118 : 1574-1582, 2016

    7 Zaidi AM, "Good outcomes from cardiac surgery in the over 70s" 82 : 134-137, 1999

    8 Rockwood K, "Frailty defined by deficit accumulation and geriatric medicine defined by frailty" 27 : 17-26, 2011

    9 손봉연 ; 최재웅 ; 황호영 ; 장명진 ; 김경환 ; 김기봉, "Frailty Index is Associated with Adverse Outcomes after Aortic Valve Replacement in Elderly Patients" 대한의학회 34 (34): 1-10, 2019

    10 Nashef SA, "EuroSCORE II" 41 : 734-745, 2012

    1 Sepehri A, "The impact of frailty on outcomes after cardiac surgery : a systematic review" 148 : 3110-3117, 2014

    2 Shahian DM, "The Society of Thoracic Surgeons 2008 cardiac surgery risk models: part 1--coronary artery bypass grafting surgery" 88 (88): S2-S22, 2009

    3 Mohr F, "TCT-43 final five-year follow-up of the SYNTAX trial : optimal revascularization strategy in patients with three-vessel disease" 60 (60): B13-, 2012

    4 Howlett SE, "Standard laboratory tests to identify older adults at increased risk of death" 12 : 171-, 2014

    5 Wu C, "Risk score for predicting long-term mortality after coronary artery bypass graft surgery" 125 : 2423-2430, 2012

    6 Sullivan PG, "Meta-analysis comparing established risk prediction models (EuroSCORE II, STS Score, and ACEF Score) for perioperative mortality during cardiac surgery" 118 : 1574-1582, 2016

    7 Zaidi AM, "Good outcomes from cardiac surgery in the over 70s" 82 : 134-137, 1999

    8 Rockwood K, "Frailty defined by deficit accumulation and geriatric medicine defined by frailty" 27 : 17-26, 2011

    9 손봉연 ; 최재웅 ; 황호영 ; 장명진 ; 김경환 ; 김기봉, "Frailty Index is Associated with Adverse Outcomes after Aortic Valve Replacement in Elderly Patients" 대한의학회 34 (34): 1-10, 2019

    10 Nashef SA, "EuroSCORE II" 41 : 734-745, 2012

    11 Altman DG, "Dangers of using"optimal"cutpoints in the evaluation of prognostic factors" 86 : 829-835, 1994

    12 Alexander JH, "Coronary-artery bypass grafting" 374 : 1954-1964, 2016

    13 Hirose H, "Coronary artery bypass grafting in the elderly" 117 : 1262-1270, 2000

    14 Mohr FW, "Coronary artery bypass graft surgery versus percutaneous coronary intervention in patients with three-vessel disease and left main coronary disease: 5-year follow-up of the randomised, clinical SYNTAX trial" 381 : 629-638, 2013

    15 Kappetein AP, "Comparison of coronary bypass surgery with drug-eluting stenting for the treatment of left main and/or three-vessel disease : 3-year follow-up of the SYNTAX trial" 32 : 2125-2134, 2011

    16 Dalrymple-Hay MJ, "Cardiac surgery in the elderly" 15 : 61-66, 1999

    17 Fruitman DS, "Cardiac surgery in octogenarians : can elderly patients benefit? : quality of life after cardiac surgery" 68 : 2129-2135, 1999

    18 Blodgett JM, "A frailty index from common clinical and laboratory tests predicts increased risk of death across the life course" 39 : 447-455, 2017

    19 Hillis LD, "2011 ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines: developed in collaboration with the American Association for Thoracic Surgery, Society of Cardiovascular Anesthesiologists, and Society of Thoracic Surgeons" 58 : e123-e210, 2011

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    2023 평가 해외DB학술지평가 신청대상 (해외등재 학술지 평가)
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    2020-01-01 등재 등재학술지 유지 (해외등재 학술지 평가) KCI등재
    2011-07-08 학술지명변경 한글명 : 대한흉부외과학회지 -> The Korean Journal of Thoracic and Cardiovascular Surgery KCI등재
    2011-01-01 등재 등재학술지 유지 (등재유지) KCI등재
    2009-01-01 등재 등재학술지 유지 (등재유지) KCI등재
    2007-01-01 등재 등재학술지 유지 (등재유지) KCI등재
    2004-01-01 등재 등재학술지 선정 (등재후보2차) KCI등재
    2003-01-01 등재 등재후보 1차 PASS (등재후보1차) KCI등재후보
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    기준연도 WOS-KCI 통합IF(2년) KCIF(2년) KCIF(3년)
    2016 0.03 0.03 0.05
    KCIF(4년) KCIF(5년) 중심성지수(3년) 즉시성지수
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