SAGE-Heart : Senior Assessment fraGility and Post-opErative QALYs 1 Year After Emergency HEART Surgery for Patients Aged 75 and Older

The advancement of structural cardiology, particularly with percutaneous valve interventions, offers new treatment options without the need for cardiopulmonary bypass (CPB). Despite an increase in the use of these techniques, some studies highlight a notable rise in CPB usage in patients aged 80 and over, from 13.8% in 2013 to 20.5% in 2022. In France, the population aged 85 and above is expected to triple by 2050, meaning more elderly patients will be eligible for CPB cardiac surgery. Several global studies have examined the outcomes of older individuals undergoing CPB cardiac surgery. While EuroSCORE II and STS scores are effective in predicting short-term mortality, they lack accuracy in predicting long-term mortality, particularly in frail patients, and do not assess quality of life. New tools to evaluate frailty, such as the Clinical Frailty Scale (CFS), are now used in preoperative assessments for planned cardiac interventions. Identifying frail elderly patients early is crucial for improving patient and family information on care plans, especially in high-risk surgeries. Even in emergencies, patients must remain involved in their health decisions, and multidisciplinary collaboration is vital for improving postoperative recovery and quality of life.

Data will be collected :

* Preoperative: During the anesthesia consultation: Calculation of the CFS (frailty assessment = CFS ≥ 4) EuroQoL 5D-5L (quality of life, with the index calculated with the French value set of the EuroQol), and routine care (renal function: urea, creatinine, albumin levels). * Postoperative (ICU and hospital): Collection of complication incidence, mortality (all causes and LATA-related). * Follow-up (by phone at 3, 6, and 12 months): CFS and EuroQoL scores, prevalence of chronic pain and analgesic use, dialysis dependency, accommodation status, readmission rates, and death date if applicable.

• Postoperative complications [Срок оценки: From surgery through,Day 28]
• All-cause mortality [Срок оценки: Through Month 12]
• EQ-5D-5L Utility Index [Срок оценки: Baseline, Month 3, Month 6, and Month 12]
• Dialysis dependence [Срок оценки: Month 3, Month 6, and Month 12]
• Length of intensive care unit stay [Срок оценки: From ICU admission to ICU discharge (assessed up to Day 28)]
• Length of hospital stay [Срок оценки: From surgery to hospital discharge]
• Hospital readmissions [Срок оценки: Month 3, Month 6, and Month 12]
• Chronic postoperative pain [Срок оценки: Month 3, Month 6, and Month 12]
• Analgesic consumption [Срок оценки: Month 3, Month 6, and Month 12]
• Living situation [Срок оценки: Month 3, Month 6, and Month 12]
• EQ-5D-5L visual analogue scale (EQ VAS) [Срок оценки: Baseline, Month 3, Month 6, and Month 12]