Latent Profile Analysis of Preoperative Frailty in Cardiac Surgery Patients: Implications for Individualised Nursing Care

OBJECTIVE: This study aimed to identify potential latent profiles of frailty among patients undergoing cardiac surgery, reveal the risk factors associated with these subgroups and understand the nursing needs of patients in different subgroups. METHODS: Patients scheduled for cardiac surgery at a tertiary general hospital in Southwest China between August 2022 and June 2023 were recruited using convenience sampling. The instruments included the General Information Questionnaire, the Chinese version of the Tilburg Frailty Indicator, the Hospital Anxiety and Depression Scale, the Mini-Mental State Examination and the Fatigue Severity Scale. Latent profile analysis was performed to identify potential classifications of preoperative frailty. Univariable and multinomial logistic regression analyses were used to determine associated influencing factors. RESULTS: A total of 261 patients were included, with a preoperative frailty prevalence of 69.7% and a median TFI score of 6 (IQR: 4-8). Latent profile analysis identified three distinct frailty phenotypes: 'multidimensional low-load frailty' (29.5%), 'social high-load frailty' (8.8%) and 'physiopsychological complex frailty' (61.7%). Multinomial logistic regression revealed significant predictors for these profiles: absence of a spouse, younger age and longer disease duration were independently associated with social high-load frailty. Higher fatigue scores increased the likelihood of physiopsychological complex frailty. Conversely, higher cognitive scores were significantly associated with the multidimensional low-load frailty profile. CONCLUSION: Preoperative frailty in cardiac surgery patients presents significant heterogeneity. Clinicians should pay particular attention to patients with social high-load frailty and physiopsychological complex frailty. Tailored nursing interventions based on these specific profiles and their associated risk factors are essential to alleviate frailty and improve patient outcomes. REPORTING METHOD: This study adhered to the STROBE guidelines for cross-sectional studies. RELEVANCE TO CLINICAL PRACTICE: Distinct frailty profiles among preoperative cardiac surgery patients were identified. Understanding these profiles enables tailored nursing interventions and potentially optimises postoperative outcomes. Implementing profile-specific care pathways can enhance perioperative patient management. PATIENT OR PUBLIC CONTRIBUTION: Patients recovering from cardiac surgery participated in reviewing the comprehensibility of survey questions for latent profiles. Members of a cardiac patient support group provided feedback on the interpretability of the findings.