Cardiothoracic & vascular anesthesia
Association of Preoperative Frailty and Postoperative Outcomes in Older Adults Undergoing Major Cardiac Procedures: A Systematic Review and Meta-Analysis
Authors' conclusion
Frailty affects nearly 1 in 5 older adults requiring major cardiac procedures. Frailty was significantly associated with adverse postoperative outcomes, including delirium, infections, renal complications, extended length of stay, and mortality.
Study context
- Population
- Older adults undergoing major cardiac procedures (coronary artery bypass grafting (CABG), aortic or mitral valve replacement or repair, transcatheter aortic valve replacement (TAVR), or combined)
- Participants
- 11,667 adults · 19 studies
- Comparison
- Frail vs non-frail
- Outcome
- Prevalence of preoperative frailty and its association with postoperative outcomes
Methodological detailsprespecified protocol, PRISMA, random-effects meta-analyses
- Prespecified protocol
- PRISMA
- Random-effects meta-analyses
Pooled result
As reported in the abstract
Prevalence of preoperative frailty and association with postoperative outcomes
Frail vs Non-frailOdds ratio (95% CI)P value
Delirium
4.11(2.00–8.45)
P < 0.001Infection
3.72(2.27–6.12)
P < 0.001Renal complications
2.72(2.05–3.60)
P < 0.00130-day mortality
3.58(2.16–5.93)
P < 0.0011-year mortality
2.25(1.56–3.25)
P < 0.001Frail vs Non-frailSMD (95% CI)P value
Hospital LOS
0.69(0.35–1.02)
P < 0.001ICU LOS
0.72(0.51–0.94)
P < 0.001- Overall prevalence of preoperative frailty
- 16.8%
Original publication
Association of Preoperative Frailty and Postoperative Outcomes in Older Adults Undergoing Major Cardiac Procedures: A Systematic Review and Meta-Analysis. Anesth Analg. Published 23 December 2025. doi:10.
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