Cardiac Surgery Frailty Index (Pre-Op) Calculator

Cardiac Surgery Frailty Index (Pre-Operative): Explanation and Clinical Context The Cardiac Surgery Frailty Index (CSFI) is a multidimensional assessment tool developed by Afilalo and colleagues to quantify preoperative frailty in patients undergoing cardiac surgery. It integrates objective and functional domains including gait speed, grip strength, cognition, anemia, hypoalbuminemia, and dependence in activities of daily living. Each deficit contributes one point to a total of six possible, forming a concise frailty profile.

Frailty reflects diminished physiological reserve and increased vulnerability to surgical stress, predicting adverse outcomes such as prolonged hospitalization, functional decline, and mortality. Patients classified as “frail” (≥3 criteria) exhibit a markedly increased risk of postoperative complications, whereas those “pre-frail” (1–2 criteria) fall in an intermediate risk zone. Assessing frailty preoperatively enables clinicians to guide shared decision-making, optimize perioperative care, and personalize rehabilitation plans.