Lower Preoperative Functional Capacity and Frailty Result in Longer Mechanical Ventilation Time and Hospital Stay in Individuals Undergoing Cardiac Surgery

Introduction: The presence of frailty and/or low Functional Capacity (FC) in the preoperative period may affect the intra-hospital evolution of individuals undergoing Cardiac Surgery (CS). Objective: To test the hypothesis that low FC and/or frailty in the preoperative period are associated with longer Mechanical Ventilation (MV) time and longer hospital stay in the postoperative period of individuals undergoing CS. Methods: A prospective and longitudinal study conducted in a private hospital. The sample included individuals of both genders, aged ≥18 years, with an indication for conventional elective cardiac surgery via median sternotomy. Functional capacity was measured by the Short Physical Performance Battery (SPPB) test, and frailty was assessed using the Clinical Frailty Scale (CFS) in the preoperative period (M0). An SPPB score between 4 and 6 indicated low FC. A CFS score of 5 or higher indicated frailty. The participants were followed throughout their hospitalization, and the MV time, ICU length of stay, and total hospital stay were evaluated. Statistical analysis used Mann-Whitney or Pearson’s Chi-square tests, with significance set at p<0.05. Results: 68 participants were included in this study (age: 60.4±11.7 years, 53.2% male). The most performed surgical procedure was valve replacement (72.1%), followed by coronary artery bypass grafting (16.2%). Low functional capacity in M0 was observed in 20.6% of participants, and 19.1% were frail. Low FC increased MV time (Yes: 2.0±2.7 vs. No: 1.0±0.1 days, p:0.00). It also increased ICU stay (Yes: 5 [3.0-7.2] vs. No: 3 [3.0-4.2] days, p:0.01) and total hospital stay (Yes: 8 [5.8-14.2] vs. No: 5 [4.8-7.0] days, p:0.00). Frailty increased MV time (Yes: 2.1±2.8 vs. No: 1.0±0.1 days, p:0.00). It also increased ICU stay (Yes: 5 [3.0-7.5] vs. No: 3 [3.0-4.0] days, p:0.01) and total hospital stay (Yes: 9 [6.58-14.5] vs. No: 5 [5.0-7.0] days, p:0.00). Conclusion: The MV time and hospital stay were longer in individuals with low FC or frailty in the preoperative period of CS.