A SYSTEMATIC REVIEW OF POSTOPERATIVE FALLS AND COMPLICATIONS IN OLDER ADULTS UNDERGOING CORONARY ARTERY BYPASS GRAFTING

Abstract

Postoperative falls represent a critical but often overlooked complication in elderly patients recovering from coronary artery bypass grafting (CABG) in Pakistan. Advanced age, combined with pre-existing cardiovascular and metabolic conditions, places these patients at heightened risk for mobility impairments, delirium, and muscle weakness after surgery. Although CABG procedures are increasingly performed within the country, comprehensive insight into postoperative trajectories for this population is still limited. This review evaluates empirical studies that have documented complications such as surgical site infections, cardiac rhythm disturbances, respiratory problems, postoperative cognitive changes, and functional decline, and explores how these outcomes influence fall risk during rehabilitation. The existing literature suggests that these complications frequently hinder mobility, prolong recovery, and elevate susceptibility to falls. Additional risk enhancers including inadequate glycemic regulation, reduced muscle strength, impaired balance, and insufficient postoperative supervision—further exacerbate vulnerability. Evidence from Pakistan remains fragmented, with minimal focus on long-term functional outcomes, fall incidence, and structured rehabilitation. The findings highlight the pressing need for coordinated postoperative management, timely mobilization practices, and standardized fall-prevention strategies to improve recovery and reduce adverse events among this high-risk group. The review also underscores major evidence gaps and calls for robust, locally conducted research to strengthen geriatric cardiac surgical care in Pakistan.