Frailty assessment before cardiac surgery
Bibliographic record
Abstract
Background: Frailty is a geriatric syndrome of increased vulnerability to stressors which has been implicated as an etiologic and prognostic factor in patients with cardiovascular disease.The American Heart Association and the Society of Geriatric Cardiology have called for a better understanding of frailty as it pertains to cardiac care in the elderly.Methods: We sought to systematically review studies of frailty in patients with cardiovascular disease.We searched Ovid MEDLINE, EMBASE, Cochrane Database, and unpublished sources.Inclusion criteria were assessment of frailty using systematically defined criteria and a study population with prevalent or incident cardiovascular disease.Results: Nine studies were included encompassing 54,250 elderly patients with a mean weighted follow-up of 6.2 years.Among community-dwelling elders, cardiovascular disease was associated with an odds ratio (OR) of 2.7-4.1 for prevalent frailty, and an OR of 1.5 for incident frailty among those who were not frail at baseline.Gait speed (a measure of frailty) was associated with an OR of 1.6 for incident cardiovascular disease.Among elderly patients with documented severe coronary artery disease or heart failure, the prevalence of frailty was 50-54% and this was associated with an OR of 1.6-4.0 for all-cause mortality after adjusting for potential confounders.Conclusion: There exists a relation between frailty and cardiovascular disease; frailty may lead to cardiovascular disease, just like cardiovascular disease may lead to frailty.The presence of frailty confers an incremental increase in mortality.The role of frailty assessment in clinical practice may be to refine estimates of cardiovascular risk which tend to be less accurate in the heterogeneous elderly patient population.
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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 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
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".