Cardiothoracic & vascular anesthesia
Preoperative rectus femoris muscle ultrasound, its relationship with frailty scores, and the ability to predict recovery after cardiac surgery: a prospective cohort study
Authors' conclusion
Preoperative RFM ultrasound examination, especially when integrated with the gait speed test, may be useful to identify patients at high risk of frailty and those with poor outcomes after cardiac surgery.
Study context
- Population
- Patients undergoing cardiac surgery
- Participants
- 85 patients
- Exposure
- Preoperative rectus femoris muscle (RFM) ultrasound vs frailty assessments
- Outcome
- Discriminative ability of RFM ultrasound measurements for frailty (CFS, GST5m) and for days at home within 30 days of surgery (DAH30)
Methodological detailsdiagnostic accuracy
- Diagnostic accuracy
Main finding
As reported in the abstract
Frailty by CFS criterion
| Group | AUC | Specificity | Positive likelihood ratio |
|---|---|---|---|
| RFM cross-sectional area | 0.76 (95% CI: 0.66-0.85) | — not stated in the abstract | — not stated in the abstract |
| Combined 'add-on' test | — not stated in the abstract | 98.7% (95% CI: 93.6%-100.0%) | 40.4 (95% CI: 5.3-304.3) |
AUC
RFM cross-sectional area0.76 (95% CI: 0.66-0.85)
Combined 'add-on' test— not stated in the abstract
Specificity
RFM cross-sectional area— not stated in the abstract
Combined 'add-on' test98.7% (95% CI: 93.6%-100.0%)
Positive likelihood ratio
RFM cross-sectional area— not stated in the abstract
Combined 'add-on' test40.4 (95% CI: 5.3-304.3)
— not stated in the abstract
- Combined 'add-on' test vs either test alone: P < 0.001 — higher predictive performance for frailty by Clinical Frailty Scale (CFS)
Observational data: associations, not effects.
Further findings
| Outcome | Combined 'add-on' test |
|---|---|
| DAH30 · 30 days | |
| AUC | 0.90 (95% CI: 0.81-0.95) |
Frailty prevalence
- Frail by CFS
- 13%
- Frail by GST5m
- 34%
DAH30 · 30 days
- May be superior to either CFS or gait speed test alone
Original publication
Preoperative rectus femoris muscle ultrasound, its relationship with frailty scores, and the ability to predict recovery after cardiac surgery: a prospective cohort study. Perioper Med (Lond). Published 23 May 2024. doi:10.
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