Combined assessment of low functional capacity and frailty in elective conventional cardiac surgery

Background Functional capacity and frailty are associated with adverse outcomes in cardiac surgery, yet their combined impact remains understudied. Objectives To evaluate the association of combined low functional capacity and frailty with post-surgical complications in patients undergoing elective cardiac surgery. Methods This prospective study included adults undergoing elective conventional cardiac surgery. Functional capacity and frailty were evaluated using the Short Physical Performance Battery (SPPB) and Clinical Frailty Scale (CFS), respectively, before surgery (M0) and at discharge (M1). A subtraction score (SPPB – CFS) was calculated. For statistical analysis, three logistic regression models were created: the crude model, model 1 including variables with statistical significance (p < 0.05) in the univariate analysis and adjusted model 2 with variables identified through Backward adjustment. The level of significance adopted was p < 0.05. Results Among 68 participants, 20.6% had low functional capacity and 18.8% were pre-frail or frail. The combined prevalence was 17.6%. Functional capacity declined postoperatively (p < 0.001). Among those with complications, 66.7% had both conditions. Individuals with complications had a lower subtraction score (p = 0.048). However, no significant association remained in adjusted regression models. Conclusion While combined low functional capacity and frailty were not associated with post-surgical complications, their presence was linked to poorer nutritional status and longer ICU and hospital stays.