RT info:eu-repo/semantics/doctoralThesis
T1 Utilidad de los test evaluadores de la sarcopenia en la estimación preoperatoria de la fragilidad y el riesgo de morbimortalidad en cirugía cardiaca
A1 Blanco Sáez, Miriam
A2 Universidad de Valladolid. Escuela de Doctorado
K1 Corazón - Cirugía
K1 Cardiacc surgery
K1 Cirugía cardíaca
K1 Frailty
K1 Fragilidad
K1 32 Ciencias Médicas
AB INTRODUCTION AND OBJECTIVESCardiovascular diseases remain the leading cause of global mortality, particularly in aging populations. Cardiac surgery, although effective, carries significant risks for frail patients—a condition characterized by a reduction in physiological reserve and resistance to stress. Frailty has emerged as a key factor in predicting postoperative morbidity and mortality, leading to the development of various scales and objective tests for its assessment.This study aims to evaluate the predictive capacity of the Grip Strength Test (GrST) and the Gait Speed Test (GST) in estimating preoperative risk in cardiac surgery, comparing them with traditional frailty scales (Barthel, Katz, Frail, Edmonton) and surgical risk stratification models (logistic EuroSCORE and EuroSCORE II).MATERIAL AND METHODSA prospective observational study was conducted in a hospital specializing in cardiac surgery. A total of 325 patients scheduled for elective surgery were included. Frailty was assessed using functional scales and objective tests (GrST and GST), collecting preoperative, intraoperative, and postoperative data. Results were analyzed using Chi-square tests, odds ratio (OR) calculations, and ROC curves, comparing the predictive ability of each tool in hospital mortality and morbidity.RESULTSFrailty and traditional scales: The Edmonton scale was the most discriminative for predicting in-hospital mortality (AUC = 0.729), while Barthel, Katz, and Frail showed limited performance.Objective tests: The GST showed a significant association with cardiogenic shock (OR: 1.636; 95% CI: 1.014-2.639), while neither GrST nor GST reached statistical significance in mortality prediction.Surgical risk models: The EuroSCORE II proved to be the most accurate tool (AUC = 0.773), followed by the logistic EuroSCORE, with moderate predictive capacity.CONCLUSIONSThe EuroSCORE II is established as the most reliable model for predicting postoperative mortality and morbidity in cardiac surgery. The Edmonton scale and GST could be considered auxiliary tools in specific contexts, whereas GrST and the Barthel and Katz scales demonstrate insufficient predictive capacity. These findings highlight the importance of a multimodal preoperative assessment to optimize surgical risk stratification.
YR 2025
FD 2025
LK https://uvadoc.uva.es/handle/10324/76235
UL https://uvadoc.uva.es/handle/10324/76235
LA spa
NO Escuela de Doctorado
DS UVaDOC
RD 10-jul-2025