&lt;p&gt;Frailty in Older Patients with Acute Coronary Syndrome in Vietnam&lt;/p&gt;

Nguyen, Tan Van; Le, Duong; Tran, Khuong Dang; Bui, Khai Xuan; Nguyen, Tu Ngoc

doi:10.2147/cia.s234597

Cited by 18 publications

(29 citation statements)

References 56 publications

(65 reference statements)

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“…Nguyen et al . recently demonstrated that frailty was associated with increased adverse outcomes in ACS patients 40 . In the present study, we adjusted for the Braden Skin Score as a marker of frailty, as this has been previously demonstrated to predict worse outcomes in CICU patients 1,26 .…”

Section: Discussionmentioning

confidence: 95%

“…39 Nguyen et al recently demonstrated that frailty was associated with increased adverse outcomes in ACS patients. 40 In the present study, we adjusted for the Braden Skin Score as a marker of frailty, as this has been previously demonstrated to predict worse outcomes in CICU patients. 1,26 Age remained associated with mortality even after adjusting for the Braden Skin Score, which itself was a strong predictor of hospital and 1 year mortality; this implicates both frailty and other age-related factors as contributors to worse outcomes.…”

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confidence: 99%

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Age and shock severity predict mortality in cardiac intensive care unit patients with and without heart failure

et al. 2020

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Aims Age is an important risk factor for mortality among patients with cardiogenic shock and heart failure (HF). We sought to assess the extent to which age modified the performance of the Society for Cardiovascular Angiography and Interventions (SCAI) shock stage for in-hospital and 1 year mortality in cardiac intensive care unit (CICU) patients with and without HF. Methods and results We retrospectively reviewed unique admissions to the Mayo Clinic CICU during 2007-2015 and stratified patients by age and SCAI shock stage. The association between age and in-hospital mortality was analysed using multivariable logistic regression, and 1 year mortality was analysed using Cox proportional hazards analysis, both in the entire cohort and among patients with an admission diagnosis of HF or acute coronary syndrome (ACS). The final study population included 10 004 unique patients with a mean age of 67 ± 15 years, including 46.1% with HF and 43.1% with ACS. Older patients more frequently had HF and had more extensive co-morbidities, higher illness severity, more organ failure, and differential use of critical care therapies. The percentage of patients with SCAI shock stages A, B, C, D, and E were 46%, 30%, 16%, 7%, and 1%, respectively. Patients with HF were older, had greater severity of illness and higher SCAI shock stage, and had higher rates of death at all time points. In-hospital mortality occurred in 908 (9%) patients, including 549 (12%) patients with HF (61% of all hospital deaths). Age was independently associated with hospital mortality (adjusted odds ratio per 10 years 1.3, 95% confidence interval 1.2-1.4, P < 0.001) and 1 year mortality (adjusted hazard ratio per 10 years 1.2, 95% confidence interval 1.2-1.3, P < 0.001) in the overall cohort. The associations of age with both hospital mortality (adjusted odds ratio 1.6 vs. 1.3 per 10 years older) and 1 year mortality (adjusted hazard ratio 1.5 vs. 1.3 per 10 years older) were higher for patients with ACS compared with patients with HF. Older age was associated with higher adjusted hospital mortality and 1 year mortality in each SCAI shock stage (all P < 0.05). Additive increases in both hospital mortality and 1 year mortality were observed with increasing age and SCAI shock stage. Conclusions Age is an independent risk factor for mortality that modifies the relationship between the SCAI shock stage and mortality risk in CICU patients, providing robust risk stratification for in-hospital and 1 year mortality. Although patients with HF had a higher risk of dying, age was more strongly associated with mortality among patients with ACS.

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Section: Discussionmentioning

confidence: 95%

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confidence: 99%

Age and shock severity predict mortality in cardiac intensive care unit patients with and without heart failure

et al. 2020

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“…In a study on 523 older adults in the northern rural areas of Vietnam, the prevalence of frailty defined by Fried's frailty phenotype was 21.7% and was associated with reduced health related quality of life [8]. In another study on 324 older patients admitted to cardiology ward of a tertiary hospital in Vietnam, frailty-defined by the Reported Edmonton Frail Scale-was present in 48.1% and associated with increased adverse outcomes such as hospital-acquired pneumonia, mortality, and readmission [9]. However, there has been no study using the CFS in older patients in Vietnam.…”

Section: Discussionmentioning

confidence: 99%

“…There is thus a need to identify frailty and to provide appropriate care for the frail seniors. The evidence of frailty in Vietnam, although limited, showed that frailty was associated with negative outcomes in older people [7][8][9][10]. Frailty research in Vietnam has evolved in the past couple of years, however there has been no study examining the use of the CFS in identifying frailty in older hospitalized patients.…”

Section: Introductionmentioning

confidence: 99%

A Pilot Study of the Clinical Frailty Scale to Predict Frailty Transition and Readmission in Older Patients in Vietnam

Nguyen

2020

IJERPH

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Background. The Clinical Frailty Scale (CFS) is gaining increasing acceptance due to its simplicity and applicability. Aims. This pilot study aims to examine the role of CFS in identifying the prevalence of frailty, frailty transition, and the impact of frailty on readmission after discharge in older hospitalized patients. Methods. Patients aged ≥60 admitted to the geriatric ward of a hospital in Vietnam were recruited from 9/2018-3/2019 and followed for three months. Frailty was assessed before discharge and after three months, using the CFS (robust: score 1-2, pre-frail: 3-4, and frail: ≥5). Multivariate logistic regression was applied to investigate the associated factors of frailty transition and the impact of frailty on readmission. Results. There were 364 participants, mean age 74.9, 58.2% female. At discharge, 4 were robust, 160 pre-frail, 200 frail. Among the 160 pre-frail participants at discharge, 124 (77.5%) remained pre-frail, and 36 (22.5%) became frail after 3 months. Age (adjusted OR1.09, 95% CI 1.03-1.16), number of chronic diseases (adjusted OR 1.37, 95% CI 1.03-1.82), and polypharmacy at discharge (adjusted OR 3.68, 95% CI 1.15-11.76) were significant predictors for frailty after 3 months. A frailty status at discharge was significantly associated with increased risk of readmission (adjusted OR2.87, 95% CI 1.71-4.82). Conclusions. Frailty was present in half of the participants and associated with increased risk of readmission. This study suggests further studies to explore the use of the CFS via phone calls for monitoring patients' frailty status after discharge, which may be helpful for older patients living in rural and remote areas.

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“…In another study on patients with ACS (37% STEMI, 41% NSTEMI, 21.9% unstable angina), 48.1% were frail according to the REFS. [ 40 ] Fewer patients with frailty underwent percutaneous coronary intervention (PCI) than those without frailty (41.7% versus 58.3%; p=0.003). After a 30-day follow-up, frailty was significantly associated with increased risk of arrhythmias during hospitalisation (adjusted OR 2.24; 95% CI [1.32–3.80]), hospital-acquired pneumonia (adjusted OR 2.27; 95% CI [1.24 4.17]), in-hospital mortality (adjusted OR 3.02; 95% CI [1.35–6.75]), 30-day mortality (adjusted OR 3.28; 95% CI [1.59–6.76]) and 30-day readmission (adjusted OR 2.53; 95% CI [1.38–4.63]), suggesting that REFS is a useful tool for identifying patients that are at risk of a poor prognosis in the short term.…”

Section: Frailty and Acute Coronary Syndromementioning

confidence: 99%

Frailty Scores and Their Utility in Older Patients with Cardiovascular Disease

et al. 2021

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The world’s population is ageing, resulting in more people with frailty receiving treatment for cardiovascular disease (CVD). The emergence of novel interventions, such as transcatheter aortic valve implantation, has also increased the proportion of older patients being treated in later stages of life. This increasing population burden makes the assessment of frailty of utmost importance, especially in patients with CVD. Despite a growing body of evidence on the association between frailty and CVD, there is no consensus on the optimal frailty assessment tool for use in clinical settings. Previous studies have shown limited concordance between validated frailty instruments. This review evaluates the evidence on the utility of frailty assessment tools in patients with CVD, and the effect of frailty on different outcomes measured.

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<p>Frailty in Older Patients with Acute Coronary Syndrome in Vietnam</p>

Cited by 18 publications

References 56 publications

Age and shock severity predict mortality in cardiac intensive care unit patients with and without heart failure

Age and shock severity predict mortality in cardiac intensive care unit patients with and without heart failure

A Pilot Study of the Clinical Frailty Scale to Predict Frailty Transition and Readmission in Older Patients in Vietnam

Frailty Scores and Their Utility in Older Patients with Cardiovascular Disease

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