World J Cardiol. Nov 26, 2026; 18(11): 127753 Published online Nov 26, 2026. doi: 10.4330/wjc.127753
Preoperative frailty and length of hospital stay after coronary artery bypass grafting
Ai-Hsiu Hung, Tsung-Neng Tsai, Wei-Chun Huang, Gen-Min Lin
Ai-Hsiu Hung, Department of Nursing, Taipei City Hospital Zhongxing Branch, Taipei 103, Taiwan
Tsung-Neng Tsai, Department of Cardiology, Tri-Service General Hospital, National Defense Medical University, Taipei 114, Taiwan
Wei-Chun Huang, Pingtung Christian Hospital, Pingtung 90059, Taiwan
Wei-Chun Huang, National Sun Yat-sen University, Kaohsiung 804, Taiwan
Gen-Min Lin, Department of Medicine, Hualien Armed Forces General Hospital, Hualien 971, Taiwan
Author contributions: Hung AH and Lin GM drafted the manuscript, synthesized data, and prepared tables; Hung AH and Tsai TN conducted the literature search and generated figures; Huang WC, Tsai TN and Lin GM critically revised the manuscript for concepts, designed future directions, and finalized the manuscript structure. All authors contributed to the critical revision and approved the final version for submission.
AI contribution statement: During the preparation of this work, the authors used Google Gemini Pro for grammar checking, copy editing, and generating illustrative Figure 1. After using this tool/service, the authors reviewed and edited the content as needed and take full responsibility for the content of the published article.
Conflict-of-interest statement: The authors declare that they have no competing or financial conflicts of interest related to this work.
Corresponding author: Gen-Min Lin, Director, FACC, FAHA, FESC, Department of Medicine, Hualien Armed Forces General Hospital, No. 100 Jinfeng Street, Hualien 971, Taiwan. farmer507@yahoo.com.tw
Received: September 7, 2026 Revised: September 27, 2026 Accepted: October 26, 2026 Published online: November 26, 2026 Processing time: 70 Days and 2.8 Hours
Abstract
Preoperative frailty - characterized by reduced physiological reserve, muscle strength, and endurance - significantly increases both 30-day and long-term mortality following coronary artery bypass grafting (CABG) surgery. Data show that frail individuals face up to a twofold to threefold higher risk of perioperative death and higher rates of complications such as acute kidney injury. However, data for the association between preoperative frailty assessed by physical activity and handgrip strength and length of hospital stay after CABG are inconsistent. In this editorial, we discuss a recently published study by Nazir et al in the World Journal of Cardiology and the discrepancy, which may reflect the predominant influence of acute surgical complications and non-clinical discharge determinants over baseline functional metrics.
Core Tip: Preoperative frailty and functional impairment robustly predict perioperative morbidity, complication rates, and long-term mortality following coronary artery bypass grafting. However, single-domain functional measures, such as handgrip strength and habitual physical activity levels, demonstrate inconsistent associations with acute postoperative length of hospital stay. This discrepancy reflects the predominant influence of acute surgical complications and non-clinical discharge determinants over baseline functional metrics. Multimodal prehabilitation and multi-domain risk stratification offer promising avenues to translate functional assessment into improved clinical trajectories.
