Frailty in elderly patients undergoing primary percutaneous coronary intervention

Calvo, Elena; Teruel, Luís; Rosenfeld, L; Guerrero, Carmen; Romero, M; Romaguera, Rafael; Edo, Sílvia; Asensio, S. García; Andreu‐Periz, Lola; Gómez‐Hospital, Joan Antoni; Arizá-Solé, Albert

doi:10.1177/1474515118796836

Cited by 22 publications

(24 citation statements)

References 33 publications

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“…The mean ages of the included patients varied between 62 and 85 years, with proportions of males varying from 46 to 75%. Multiple tools were used for the evaluation of frailty among the included studies, including the Fried Frailty Criteria ( 15 , 17 ), the Canadian Study of Health and Aging Clinical Frailty Scale ( 16 , 22 ), validated frailty phenotype criteria ( 23 ), FRAIL scale ( 18 ), Claims-based Frailty Index ( 19 ), Safety Management Programme Score ( 20 ), Hospital Frailty Risk Score ( 24 ), and modified KATZ index ( 21 ). A total of 16,183 patients were considered with frailty at baseline.…”

Section: Resultsmentioning

confidence: 99%

“…Among them, 1,082 studies were further excluded because they were not related to the purpose of the meta-analysis based on titles and abstracts. Then, for the remaining 42 studies evaluated by full text reading, 32 were not included for the reasons presented in Figure 1, which resulted in ten cohort studies finally analyzed in the meta-analysis (15)(16)(17)(18)(19)(20)(21)(22)(23)(24).…”

Section: Database Searchmentioning

confidence: 99%

“…However, the association between frailty and the prognosis of patients after PCI remains unclear (14). Most studies showed that frailty is independently associated with higher risk of mortality and adverse events after PCI (15)(16)(17)(18)(19)(20)(21)(22), while some did not (23,24). Accordingly, a previous meta-analysis included eight cohort studies and showed that frailty was associated with a higher risk of death for patients after PCI (25).…”

mentioning

confidence: 99%

“…Besides, this meta-analysis included studies with univariate analysis and a study using continuous gait speed as the indicator of frailty (28), which made the results of the metaanalysis difficult to interpret. Since several relevant cohort studies (17)(18)(19)(20)(21)(22)24) have been published since the previous meta-analysis, we aimed to perform an updated meta-analysis to summarize the current understanding for the association between frailty and prognosis after PCI.…”

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confidence: 99%

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Frailty Predicts Poor Prognosis of Patients After Percutaneous Coronary Intervention: A Meta-Analysis of Cohort Studies

Wang

Zhang

et al. 2021

Front. Med.

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Background: Frailty has been related to a higher risk of cardiovascular events, while the association between frailty and outcomes for patients with coronary artery disease (CAD) after percutaneous coronary intervention (PCI) remains unclear. We performed a meta-analysis of cohort studies to evaluate the above association.Methods: Cohort studies aiming to determine the potential independent association between frailty and clinical outcomes after PCI were identified by search of PubMed, Embase, and Web of Science databases from inception to February 22, 2021. A random-effects model that incorporates the possible heterogeneity among the included studies was used to combine the results.Results: Ten cohort studies with 7,449,001 patients were included. Pooled results showed that frailty was independently associated with higher incidence of all-cause mortality [adjusted risk ratio (RR) = 2.94, 95% confidence intervals (CI): 1.90–4.56, I2 = 56%, P < 0.001] and major adverse cardiovascular events [(MACEs), adjusted RR = 2.11, 95% CI: 1.32–3.66, I2 = 0%, P = 0.002]. Sensitivity analyses limited to studies including elderly patients showed consistent results (mortality: RR = 2.27, 95% CI: 1.51–3.41, I2 = 23%, P < 0.001; MACEs: RR = 2.44, 95% CI: 1.44–4.31, I2 = 0%, P = 0.001). Subgroup analyses showed that characteristics of study design, follow-up duration, or type of PCI did not seem to significantly affect the associations (P-values for subgroup analyses all >0.05).Conclusions: Frailty may be an independent risk factor of poor prognosis for patients with CAD after PCI.

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confidence: 99%

Section: Database Searchmentioning

confidence: 99%

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Frailty Predicts Poor Prognosis of Patients After Percutaneous Coronary Intervention: A Meta-Analysis of Cohort Studies

Wang

Zhang

et al. 2021

Front. Med.

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“…En el presente trabajo se encontró que los pacientes que fallecieron durante el estudio tuvieron un promedio de edad de 80,29 ± 7,78 años, con diferencias significativas, similar a lo encontrado en un estudio longitudinal chino realizado por Yang et al (25) . Además, la distribución con respecto a sexo fue similar a la de la investigación realizada por Charlson et al (26) , datos que discrepan de Calvo et al (27) , en cuyo estudio predominaron las mujeres. Una de las posibles razones de este hallazgo es que existe un sesgo institucional probable ya que en esta investigación participó personal militar retirado y sus familiares.…”

Section: Resultsunclassified

Riesgo de mortalidad según el índice de Charlson en comparación con el índice de fragilidad en pacientes adultos mayores del Centro Médico Naval entre los años 2010 al 2015

et al. 2020

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Objetivo: Medir el riesgo de mortalidad con el índice de fragilidad, el índice de Charlson y el Short Physical Performance Battery (SPPB) en pacientes adultos mayores. Los tres esquemas son útiles para la evaluación y posterior enfoque del paciente geriátrico. Materiales y métodos: Estudio observacional, transversal, analítico, secundario a una base de datos, con un muestreo no probabilístico y de tipo por conveniencia. La base de datos se obtuvo del estudio original "Prevalencia y factores asociados con la fragilidad en adultos mayores peruanos", realizado entre los años 2010 y 2015, en el Servicio Geriátrico del Centro Médico Naval "Cirujano Mayor Santiago Távara". En total, se incluyeron 1897 participantes mayores de 60 años. Resultados: Los valores de fragilidad encontrados fueron 51,33 % (según el índice de fragilidad), 26,16 % (de acuerdo al SPPB), y 73,47 % (al aplicar el índice de Charlston). La frecuencia de mortalidad en el estudio fue del 10,13 %. Conclusiones: Los tres índices comparados en este estudio presentaron significancia para predecir fragilidad. Sin embargo, cuando se realiza el modelo ajustado por sexo, se demuestra que el SPPB y el Índice de Charlson presentan una mayor significancia estadística.

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Prevalence and adverse outcomes of frailty in older patients with acute myocardial infarction after percutaneous coronary interventions: A systematic review and meta‐analysis

Guo

Peng

et al. 2022

Clinical Cardiology

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Background The association between frailty and older patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI) is unclear. Therefore, we conducted a systematic review and meta‐analysis to investigate the prevalence of frailty in older patients with AMI following PCI, and determine the relationship between frailty and adverse outcomes in these patients. Hypothesis Older patients with AMI have a higher prevalence of frailty after PCI, and the frailty in these patients increases the risk of adverse outcomes. Methods A comprehensive search of the PubMed, Cochrane, Ovid (Medline), Ovid (Embase), and Web of Science databases was performed for articles published until October 2021. A meta‐analysis was performed using stata12.0 software. A random‐effects model was used when I 2 was greater than 50%; otherwise, a fixed‐effects model was used. Results There were a total of 274,976 older patients in the included studies. Nine studies investigated the prevalence of frailty in older patients with AMI after PCI, with an overall prevalence of 39% (95% confidence interval [CI]: 18%–60%, p < .001). Six studies included adverse outcomes of frailty in older patients with AMI after PCI, including all‐cause mortality (hazard ratio [HR] = 2.29, 95% CI: 1.65–3.16, p = .285), rehospitalization (HR = 2.53, 95% CI: 1.38–4.63), and in‐hospital major bleeding (HR = 1.93, 95% CI: 1.29–2.90, p = .825). Conclusion The frailty prevalence is increased in older patients with AMI after PCI, especially in ST‐segment elevation myocardial infarction (STEMI). AMI with frailty after PCI is more likely to be associated with worse clinical outcomes, such as death, bleeding, and rehospitalization.

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Frailty in elderly patients undergoing primary percutaneous coronary intervention

Abstract: A not negligible proportion of elderly patients with STEMI fulfilled the frailty criteria. Frailty was independently associated with mortality. A very simple, feasible geriatric assessment by trained nurses can contribute to predict mortality.

Cited by 22 publications

References 33 publications

Frailty Predicts Poor Prognosis of Patients After Percutaneous Coronary Intervention: A Meta-Analysis of Cohort Studies

Frailty Predicts Poor Prognosis of Patients After Percutaneous Coronary Intervention: A Meta-Analysis of Cohort Studies

Riesgo de mortalidad según el índice de Charlson en comparación con el índice de fragilidad en pacientes adultos mayores del Centro Médico Naval entre los años 2010 al 2015

Prevalence and adverse outcomes of frailty in older patients with acute myocardial infarction after percutaneous coronary interventions: A systematic review and meta‐analysis

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