• Judith McKinlay, Aloysius Ng, and Leena Nagappan.
• South Metropolitan Health Service, Fiona Stanley Hospital, Murdoch, Western Australia, Australia. Electronic address: judith.mckinlay@health.wa.gov.au.
• J. Cardiothorac. Vasc. Anesth. 2024 Sep 7.

ObjectiveTo assess if frailty scoring can predict increased frailty and care dependence requiring a change in living situation in patients with peripheral artery disease (PAD) following major vascular surgery.DesignA single center, retrospective cohort study.SettingFiona Stanley Hospital, a tertiary center located in Perth, Western Australia.ParticipantsSeventy-nine patients with PAD who underwent major vascular surgery at the study hospital in 2022 were enrolled.InterventionBaseline Clinical Frailty Scale (CFS) scores were assigned retrospectively. A quantitative analysis using two partitions, CFS 1-3 (not frail) versus 4-9 (frail) was used. Cases were screened for hospital-acquired complications, and records were reviewed to assess the level of care dependence at the time of discharge and 6 months following.Measurements And Main ResultsThe primary outcome was to assess if frailty predicts increased care dependence. Secondary outcomes included unplanned readmissions and hospital-acquired complications in this cohort. A logistic regression was performed to predict the effects of age and baseline, discharge, and 6-month CFS on the likelihood of change in living situation. Baseline frailty was associated with a higher frailty score at discharge (p = 0.001), which persisted at 6 months (p = 0.001). There was no difference in American Society of Anesthesiologists classification, sex, age, 30-day mortality, or in-hospital complications between groups. After correcting for age, a lower baseline CFS (odds ratio 0.19, confidence interval 0.04-0.84, p = 0.028) and discharge CFS (odds ratio 34.00, confidence interval 3.88-298.42, p = 0.001) predicts the likelihood of patients having a change in living situation after surgery.ConclusionsFrail patients with PAD undergoing major vascular surgery are at significant risk of functional decline, necessitating a change in living situation to meet their increased care needs. This increased care dependence persisted 6 months following discharge.Copyright © 2024 Elsevier Inc. All rights reserved.

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