Send to

Choose Destination
Clin Cardiol. 2018 Aug;41(8):1103-1110. doi: 10.1002/clc.23021. Epub 2018 Aug 17.

The incremental predictive value of frailty measures in elderly patients undergoing cardiac surgery: A systematic review.

Author information

Department of Epidemiology & Biostatistics, Western University, London, Ontario.
Chinese Academy of Medical Sciences, Fuwai Hospital, Beijing, China.


Emerging evidence demonstrates that frailty measures can predict adverse outcomes after cardiac procedures. Our objectives were to examine whether the inclusion of frailty measures adds incremental predictive value to existing surgical risk prediction models in patients undergoing cardiac surgery and to evaluate the reporting and methods of studies that investigated the prediction of frailty measures in cardiology. The inclusion of frailty measures adds incremental predictive value on existing perioperative risk-scoring systems. We systematically searched the EMBASE, MEDLINE, and Web of Science databases for relevant studies. Studies were included according to predefined inclusion criteria. The quality of included studies was appraised using the QUADAS-2 tool. Data were extracted and synthesized according to predefined methods. Twelve studies were included in the analysis. Included studies demonstrated the incremental predictive value of frailty measures on existing surgical risk models for mortality, but the predictive value of frailty measures alone was not consistent across literature. Few studies that investigated the predictive ability of frailty measures reported all important model performance measures. When comparing the predictive value of frailty measures with existing models, few studies reported if the frailty measurement was separately performed from the existing perioperative risk assessment. The addition of frailty measures to the existing perioperative risk models improved the prediction performance for mortality, but the incorporation of frailty assessment into perioperative risk assessment requires further evidence before making health policy recommendations.


cardiac surgery; frailty; perioperative; predictive value

[Indexed for MEDLINE]
Free full text

Supplemental Content

Full text links

Icon for Wiley
Loading ...
Support Center