Frailty and Dependency in Older Adults Undergoing Cardiac Surgery

N/AActive Not RecruitingNCT07755254

Aydin Adnan Menderes University187 enrolled

Overview

Frailty and dependency are common conditions among older adults undergoing cardiac surgery and may adversely affect postoperative recovery and readiness for hospital discharge. Early identification of these conditions before surgery may facilitate individualized perioperative care and improve postoperative outcomes. This observational study aims to investigate the effects of preoperative frailty and dependency on postoperative recovery and readiness for hospital discharge in older patients undergoing cardiac surgery. Data will be collected before surgery and at hospital discharge using validated assessment instruments. The findings are expected to support preoperative risk assessment and contribute to individualized nursing care planning for older cardiac surgery patients.

The growing elderly population has resulted in an increasing number of older adults undergoing cardiac surgery. Age-related physiological decline, multiple comorbidities, polypharmacy, and reduced physiological reserve increase vulnerability to adverse postoperative outcomes. Frailty and dependency are common geriatric conditions that may influence postoperative recovery, functional status, and readiness for discharge. Frailty is characterized by increased vulnerability to stressors because of diminished physiological reserve, whereas dependency reflects limitations in performing activities of daily living independently. Identifying these conditions before surgery may facilitate early recognition of patients at risk for delayed recovery and inadequate discharge readiness. This single-center observational study will be conducted in the Cardiovascular Surgery Clinic of Aydın Adnan Menderes University Research and Application Hospital. Patients aged 65-85 years scheduled to undergo cardiac surgery will be recruited consecutively. Before surgery, participants will complete the Patient Information Form, the FRAIL Scale, and the Katz Activities of Daily Living Scale. At hospital discharge, postoperative recovery will be evaluated using the Postoperative Recovery Index, and readiness for hospital discharge will be assessed using the Readiness for Hospital Discharge Scale-Short Form. The primary objective is to determine the effects of preoperative frailty and dependency on postoperative recovery and readiness for hospital discharge among older adults undergoing cardiac surgery. The findings are expected to improve perioperative risk assessment and contribute to evidence-based nursing care planning.

Study Type

OBSERVATIONAL

Eligibility

Sex: ALLMin age: 65 YearsMax age: 85 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Age between 65 and 85 years * Scheduled to undergo cardiac surgery (coronary artery bypass graft surgery, * Bentall procedure, heart valve surgery, or aneurysm surgery) * No surgical history within the previous two months * Able to read and write Turkish * No hearing impairment * Willing to participate and provide written informed consent Exclusion Criteria: * Surgery within the previous eight weeks * Diagnosis of a psychiatric disorder * Withdrawal of consent during the study * Incomplete study questionnaires

Outcomes

Primary Outcomes

Postoperative Recovery

Postoperative recovery will be assessed using the Postoperative Recovery Index. The scale consists of 5 subdimensions and 25 items. The subdimensions are: psychological symptoms, physical activities, general symptoms, bowel symptoms, and desire symptoms. When determining subdimension scores, the scores of the relevant items are summed and their arithmetic mean is calculated. For the total score, all items are summed and their arithmetic mean is calculated. High scores on the index reflect greater difficulties in postoperative recovery, while low scores indicate easier postoperative recovery.

Time frame: At hospital discharge (approximately postoperative day 6)

Readiness for Hospital Discharge

Readiness for hospital discharge will be assessed using the Readiness for Hospital Discharge Scale-Short Form. The scale consists of 8 questions and 4 sub-dimensions: personal situation, knowledge, coping, and expected support. The questions are evaluated on a scale of '0=not ready' to '10=completely ready'. A total score of 0-80 can be obtained from the scale based on the answers given to the questions; a higher score indicates a higher level of readiness for discharge. On the scale dimensions, a score of 7 and above indicates readiness for discharge, while a score below 7 indicates readiness for discharge.

Time frame: At hospital discharge (approximately postoperative day 6)

Secondary Outcomes

Frailty

Frailty will be assessed using the FRAIL Scale. The scale consists of five items evaluating fatigue, resistance, ambulation, illnesses, and weight loss. Higher scores indicate greater frailty. The minimum score obtainable from the scale is between "0" (zero) and "5" (five). There is no cutoff score for the scale; it is interpreted that an increase in the score indicates an increase in the level of vulnerability.

Time frame: One day before surgery (Baseline)

Dependency in Activities of Daily Living

Dependency will be assessed using the Katz Activities of Daily Living Scale. The instrument evaluates independence in six basic daily living activities. As the scores obtained from the scale increase, it is interpreted as an increase in difficulty in performing daily living activities and an increase in dependence. Based on the scores obtained from the scale, 0-2 is classified as dependent, 3-4 as semi-dependent, and 5-6 as independent.