The Frail Scale – A Risk Stratification in Older Patients with Acute Coronary Syndrome

Abstract

Purpose The aim of this study was to explore the impact of frailty on in-hospital adverse outcomes and net adverse clinical events (NACE) in older patients with acute coronary syndrome. Patients and Methods This observational study included elderly patients (≥60 years old), diagnosed with acute coronary syndrome (ACS) at admission from February 2021 to August 2021. The primary outcome was net adverse clinical events (NACE) defined as a composite of all-cause mortality, stroke, and major bleeding. Secondary outcome was in-hospital adverse outcomes including arrhythmia, acquired pneumonia, stroke, major bleeding, and all-cause mortality. Frailty was assessed using the Frail scale (FS). Data about socio-demographics, comorbidities, body mass index, ACS type, coronary angiography, left ventricular ejection fraction, and length of hospital stay were also collected. Univariate and multivariate logistic regressions were employed to identify the potential association between frailty and outcomes. Results Of the 116 ACS patients, 38 patients were frail (32.76%). Frail subjects were more often female (50%) and older (p < 0.01) and had higher rates of in-hospital adverse outcomes (OR = 2.37, p = 0.05) and NACE (OR = 7.12; p < 0.01). In univariate analysis, the increased frail score was significantly associated with increased odds of NACE (unadjusted OR = 1.98, 95% CI 1.17–3.35 for each score increase in Frail Score). In multivariable logistic regression, models controlling for age, gender, PCI, LVEF, and coronary angiography (adjusted OR 2.19, 95% CI 1.12–4.29 for each score increase in Frail Score). Conclusion This study revealed the reference data of frailty assessment in older patients with ACS in Vietnam. Our result indicated that over 30% of ACS older patients presented with frailty which was associated with an increased risk of in-hospital adverse outcomes and NACE. This study also provided promising information about the simple FRAIL scale’s potential role in the risk stratification of older patients with ACS.

To determine the frequency of triple vessel coronary artery disease in patients admitted with acute coronary syndrome.

“…A research study in Vietnam documented the data for assessment of frailty in patients of acute coronary syndrome. 13 He also found that single vessel disease was most commonly involved being 60%. 14.5% patients had double vessel involvement.…”

Viewpoint on “The Frail Scale – A Risk Stratification in Older Patients with Acute Coronary Syndrome” [Letter]

“…We appreciate the authors’ paper titled “Evaluation of the Frail Scale - A Risk Stratification in Older Patients with Acute Coronary Syndrome” by Anh Phuong et al 1 We acknowledge the significance of their findings in the field of health education. As readers, we would like to share our perspectives on this study and offer input that can contribute to the further development of this research for future researchers interested in testing the frail scale.…”

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We appreciate the authors' paper titled "Evaluation of the Frail Scale -A Risk Stratification in Older Patients with Acute Coronary Syndrome" by Anh Phuong et al 1 We acknowledge the significance of their findings in the field of health education. As readers, we would like to share our perspectives on this study and offer input that can contribute to the further development of this research for future researchers interested in testing the frail scale.The study conducted by Anh Phuong et al aimed to investigate the influence of frailty on in-hospital adverse outcomes and net adverse clinical events (NACE) in older patients diagnosed with acute coronary syndrome (ACS).

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