An Easy Assessment of Frailty at Baseline Independently Predicts Prognosis in Very Elderly Patients With Acute Coronary Syndromes
Por:
Alegre, O, Formiga, F, Lopez-Palop, R, Marin, F, Vidan, MT, Martinez-Selles, M, Carol, A, Sionis, A, Diez-Villanueva, P, Aboal, J, Palau-Vendrel, A, Bueno, H, Rivera, AP, Sanchis, J, Abu-Assi, E, Corbi, M, Castillo, JC, Baneras, J, Gonzalez-Salvado, V, Cequier, A, Ariza-Sole, A
Publicada:
1 abr 2018
Resumen:
Background: Information about the impact of frailty in patients with acute coronary syndromes (ACS) is scarce. No study has assessed the prognostic impact of frailty as measured by the FRAIL scale in very elderly patients with ACS.
Methods: The prospective multicenter LONGEVO-SCA registry included unselected patients with ACS aged 80 years or older. A comprehensive geriatric assessment was performed during hospitalization, including frailty assessment by the FRAIL scale. The primary endpoint was mortality at 6 months.
Results: A total of 532 patients were included. Mean age was 84.3 years, 61.7% male. Most patients had positive troponin levels (84%) and high GRACE risk score values (mean 165). A total of 205 patients were classified as prefrail (38.5%) and 145 as frail (27.3%). Frail and prefrail patients had a higher prevalence of comorbidities, lower left ventricle ejection fraction, and higher mean GRACE score value. A total of 63 patients (11.8%) were dead at 6 months. Both prefrailty and frailty were associated with higher 6-month mortality rates (P <. 001). After adjusting for potential confounders, this association remained significant (hazard ratio [HR] 2.71; 95% confidence interval [CI] 1.09-6.73 for prefrailty and HR 2.99; 95% CI 1.20-7.44 for frailty, P = .024). The other independent predictors of mortality were age, Charlson Index, and GRACE risk score.
Conclusions: The FRAIL scale is a simple tool that independently predicts mortality in unselected very elderly patients with ACS. The presence of prefrailty criteria also should be taken into account when performing risk stratification of these patients. (C) 2017 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
Filiaciones:
Alegre, O:
Hosp Univ Bellvitge, Barcelona, Spain
Formiga, F:
Hosp Univ Bellvitge, Barcelona, Spain
Lopez-Palop, R:
Hosp Univ San Juan, Alicante, Spain
Marin, F:
Hosp Univ Virgen Arrixaca, IMIB Arrixaca, CIBER CV, Murcia, Spain
Vidan, MT:
Hosp Gen Univ Gregorio Maranon, Madrid, Spain
Martinez-Selles, M:
Hosp Gen Univ Gregorio Maranon, Madrid, Spain
Univ Europea, Univ Complutense, CIBERCV, Madrid, Spain
Carol, A:
Hosp Moises Broggi, Barcelona, Spain
Sionis, A:
Hosp Santa Creu & Sant Pau, Barcelona, Spain
Diez-Villanueva, P:
Hosp Unversitario La Princesa, Madrid, Spain
Aboal, J:
Hosp Univ Josep Trueta, Girona, Spain
Palau-Vendrel, A:
Hosp Santa Tecla, Tarragona, Spain
Bueno, H:
Hosp Doce de Octubre, Madrid, Spain
Ctr Nacl Invest Cardiovasc, Madrid, Spain
Rivera, AP:
Hosp Univ Burgos, Burgos, Spain
Sanchis, J:
Univ Valencia, CIBER CV Valencia, Spain Instead Hosp Clin Valencia, Hosp Clin Valencia,INCLIVA, Valencia, Spain
Abu-Assi, E:
Hosp Alvaro Cunqueiro, Vigo, Spain
Corbi, M:
Hosp Gen Albacete, Albacete, Spain
Castillo, JC:
Hosp Reina Sofia, Cordoba, Spain
Baneras, J:
Hosp Valle De Hebron, Barcelona, Spain
Gonzalez-Salvado, V:
Complejo Hosp Univ Santiago, Santiago De Compostela, Spain
Cequier, A:
Hosp Univ Bellvitge, Barcelona, Spain
Ariza-Sole, A:
Hosp Univ Bellvitge, Barcelona, Spain
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