FRAIL Scale also Predicts Long-Term Outcomes in Older Patients With Acute Coronary Syndromes

Rodriguez-Queralto, Oriol; Formiga, Francesç; López-Palop, Ramón; Marı́n, Francisco; Vidán, María Teresa; Martínez‐Sellés, Manuel; Díez‐Villanueva, Pablo; Sanchís, Juan; Corbi, Miguel; Aboal, Jaime; Bernal, Eva; Alegre, Oriol; Vicent, Lourdes; Arizá-Solé, Albert

doi:10.1016/j.jamda.2019.10.007

Cited by 21 publications

(20 citation statements)

References 18 publications

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“…In previous studies of hospitalized patients, Clinical Frailty Scale (CFS), FI, and frailty phenotype were commonly used [27]. In the acute care setting, the simple CFS, and the 5-item FRAIL questionnaire were used more often than FI and frailty phenotype, which typically required more time and modifications to the original definition [34][35][36]. Although simpler measures of frailty may be useful for rapid detection of who might be frail, a more sophisticated tool, such as comprehensive geriatric assessment (CGA)-based FI, should be followed to assess and confirm the severity of frailty for clinical management [37].…”

Section: Discussionmentioning

confidence: 99%

Frailty and hospitalization-associated disability after pneumonia: A prospective cohort study

et al. 2021

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Background Pneumonia is a major cause of morbidity and mortality in older adults. The role of frailty assessment in older adults with pneumonia is not well defined. Our purpose of the study was to investigate 30-day clinical course and functional outcomes of pneumonia in older adults with different levels of frailty. Methods A prospective cohort was conducted at a university hospital in Seoul, Korea with 176 patients who were 65 years or older and hospitalized with pneumonia. A 50-item deficit-accumulation frailty index (FI) (range: 0–1; robust < 0.15, pre-frail 0.15–0.24, mild-to-moderately frail 0.25–0.44, and severely frail ≥ 0.45) and the pneumonia severity CURB-65 score (range: 0–5) were measured. Primary outcome was death or functional decline, defined as worsening dependencies in 21 daily activities and physical tasks in 30 days. Secondary outcomes were intensive care unit admission, psychoactive drug use, nasogastric tube feeding, prolonged hospitalization (length of stay > 15 days), and discharge to a long-term care institution. Results The population had a median age 79 (interquartile range, 75–84) years, 68 (38.6 %) female, and 45 (25.5 %) robust, 36 (47.4 %) pre-frail, 37 (21.0 %) mild-to-moderately frail, and 58 (33.0 %) severely frail patients. After adjusting for age, sex, and CURB-65, the risk of primary outcome for increasing frailty categories was 46.7 %, 61.1 %, 83.8 %, and 86.2 %, respectively (p = 0.014). The risk was higher in patients with frailty (FI ≥ 0.25) than without (FI < 0.25) among those with CURB-65 0–2 points (75 % vs. 52 %; p = 0.022) and among those with CURB-65 3–5 points (93 % vs. 65 %; p = 0.007). In addition, patients with greater frailty were more likely to require nasogastric tube feeding (robust vs. severe frailty: 13.9 % vs. 60.3 %) and prolonged hospitalization (18.2 % vs. 50.9 %) and discharge to a long-term care institution (4.4 % vs. 59.3 %) (p < 0.05 for all). Rates of intensive care unit admission and psychoactive drug use were similar. Conclusions Older adults with frailty experience high rates of death or functional decline in 30 days of pneumonia hospitalization, regardless of the pneumonia severity. These results underscore the importance of frailty assessment in the acute care setting.

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Section: Discussionmentioning

confidence: 99%

Frailty and hospitalization-associated disability after pneumonia: A prospective cohort study

et al. 2021

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“…Elderly patients have a higher risk of postoperative complications and a higher mortality rate compared with other age groups 19 . Frailty has been linked to an increased risk of poor outcomes in several diseases 11–14 . However, the efficacy of frailty assessment in GI diseases has been rarely studied.…”

Section: Discussionmentioning

confidence: 99%

“…The relationship between frailty and the outbreak of various diseases, such as orthopedic, cardiovascular, brain and urinary diseases, have been extensively reported 11–14 . However, the impact of the preoperative assessment of frailty in gastrointestinal (GI) disease remains insufficiently evaluated.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of preoperative frailty assessment in patients with gastrointestinal disease

Kameyama

Sakata

Hanyu

et al. 2021

Geriatrics Gerontology Int

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Aim The role of preoperative frailty assessment in patients with gastrointestinal (GI) disease remains unclear. This study aimed to clarify the relationship between frailty and postoperative outcomes in patients with GI disease. Methods This study investigated 42 patients (aged ≥65 years) with GI disease who underwent abdominal surgery. The frailty status was analyzed using the Japanese version of the Cardiovascular Health Study criteria. We also investigated postoperative outcomes. Results Of the 42 patients, seven (16.7%) were robust, 24 (57.1%) were prefrail and 11 (26.2%) were frail. Postoperative complications were observed in 45.5% and 63.6% of prefrail and frail patients, respectively, whereas no complications were found in robust patients (P = 0.026). The median hospital stay was 15, 19.5 and 27 days in robust, prefrail and frail patients, respectively (P < 0.01). Conclusion Preoperative frailty status based on the Japanese version of the Cardiovascular Health Study criteria is associated with postoperative complication incidence and hospital stay extension in patients with GI disease. Geriatr Gerontol Int 2021; ••: ••–••.

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“…As many as 10% of ≥65 years and 25-50% of ≥85 years patients admitted with ACS are frail. Frailty strongly associates worse events in the short and long-term in NSTEMI elderly patients [48][49][50]. Cardiac rehabilitation (CR) programs have proven to provide significant benefits after an ischemic event, though a low proportion of elderly patients are referred [51].…”

Section: Geriatric Syndromesmentioning

confidence: 99%

Non-ST segment elevation myocardial infarction in the elderly

Jiménez-Méndez¹,

Díez‐Villanueva²,

Alfonso³

2021

Reviews in Cardiovascular Medicine

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Ischemic heart disease constitutes the leading cause of death in Western countries. The general incidence of acute coronary syndromes (ACS), especially non-ST segment elevation myocardial infarction (NSTEMI), is growing. Advanced age is both a strong risk factor for ACS and an independent predictor of poorer clinical outcomes. Management of this entity is often complex in the elderly, while special attention should be focused on comorbidities and geriatric conditions. This article aims to review clinical presentation, identification and management of NSTEMI in the elderly population.

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FRAIL Scale also Predicts Long-Term Outcomes in Older Patients With Acute Coronary Syndromes

Cited by 21 publications

References 18 publications

Frailty and hospitalization-associated disability after pneumonia: A prospective cohort study

Frailty and hospitalization-associated disability after pneumonia: A prospective cohort study

Efficacy of preoperative frailty assessment in patients with gastrointestinal disease

Non-ST segment elevation myocardial infarction in the elderly

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