Abstract 147: Subtle Degrees of Frailty Result in Adverse Cardiac Surgery Outcomes
Bibliographic record
Abstract
Background: In North America, octogenarians are the fastest growing demographic. Chronological age of a patient is not always the same as their biological age, and their biological status can vary from robust to frail. Frail patients are predisposed to falls, institutionalization, hospitalization, and mortality. In the realm of cardiac surgery, there is little research examining frailty as a risk factor for cardiac surgical intervention. Purpose: The objective of the current study is to explore the relationship between more subtle degrees of frailty and cardiac surgical outcomes in more detail. Methods: This non-interventional study subjects all consented participants fitting inclusion criteria to the same questionnaires. The assessment is comprised of the Frailty Assessment for Care-Planning Tool (FACT) for both patient and their collateral, and the EQ-5D-3L. A similar interview process is repeated 5-7 months after surgery, with the addition of a qualitative interview. Results: Pilot study results (n=57) show that 52% of the participants were positive for at least one category of frailty at a level of 4/7 (vulnerable). Results also demonstrated that 3.8% of participants who scored zero deficits on the FACT were discharged to an institution for follow up care compared to 19.3% of participants with one or more deficits. Conclusions: Overall, participants were much frailer than expected, with over half being considered vulnerable or worse on the FACT scale. This signifies an increase in frailty in the elderly population, which supplies rationale for the current study. This study will analyze a larger sample of elderly cardiac surgery patients in the Atlantic provinces to more thoroughly investigate this relationship. Implications: This study will assist in educating future heart surgery patients about their possible risks. It is hoped that patients who possess more knowledge about their personal risks will be able to make more informed decisions about their surgery. Strategies to address and reduce frailty by increasing mobility and cognitive function and reducing nutritional deficiencies could use this information to inform future work.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.021 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".