An Easy Assessment of Frailty at Baseline Independently Predicts Prognosis in Very Elderly Patients With Acute Coronary Syndromes
| Autor: | Oriol Alegre, Francesc Formiga, Ramón López-Palop, Francisco Marín, María T. Vidán, Manuel Martínez-Sellés, Antoni Carol, Alessandro Sionis, Pablo Díez-Villanueva, Jaime Aboal, Anna Palau-Vendrel, Héctor Bueno, Angel Perez Rivera, Juan Sanchís, Emad Abu-Assi, Miguel Corbí, Juan C. Castillo, Jordi Bañeras, Violeta González-Salvado, Àngel Cequier, Albert Ariza-Solé, Agnes Rafecas, Cinta Llibre, Miquel Vives, Pau Vilardell, Alfredo Bardají, Carlos Tomás, Oscar Macho, Manuel Peraire, Ana Lacal, Anna Palau, Vanessa Martínez-García, Núria Coma, Marta Campreciós, Susana Herranz, Sergi Yun, Maria Orriols, Josep Mª Viguer, Juan Carlos Castillo, Víctor Becerra, Pilar Cardila, Javier López Díaz, Héctor García-Pardo, Jose Ángel Perez-Rivera, Ana Merino Merino, Francisco Martín-Herrero, Maria Isabel Garcimartín, Clara Bonanad, Óscar Fabregat, Vícto Pérez-Roselló, Ramon López-Palop, Miguel Rodríguez-Santamarta, Bernardo García de la Villa, Luis Asmarats, Jaume Maristany, Joan Torres, Marta Gómez-Llorente, Martín Jesús García-González, Raquel Pimienta, Ana Viana-Tejedor, Iván Núñez-Gil, Juan Ruiz-García, Alejandro Cortés Beringola, Mariá T. Vidán, Aitziber Munárriz, Nahikari Salterain |
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| Rok vydání: | 2017 |
| Předmět: |
Background information
Male medicine.medical_specialty Time Factors Frail Elderly Enfermedad cardiovascular Anciano Comorbidity Kaplan-Meier Estimate 030204 cardiovascular system & hematology Risk Assessment 03 medical and health sciences 0302 clinical medicine Internal medicine Cause of Death Clinical endpoint Prevalence Medicine Humans In patient 030212 general & internal medicine Prospective Studies Registries Acute Coronary Syndrome General Nursing Proportional Hazards Models Aged 80 and over Framingham Risk Score Ejection fraction biology Frailty business.industry Health Policy Mortality rate Geriatric assessment General Medicine Prognosis Troponin Survival Analysis Spain biology.protein Cardiopatía coronaria Female Geriatrics and Gerontology business Ancianos |
| Zdroj: | Journal of the American Medical Directors Association. 19(4) |
| ISSN: | 1538-9375 |
| Popis: | 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. Sin financiación 4.899 JCR (2018) Q1, 6/53 Geriatrics & Gerontology 2.123 SJR (2018) Q1, 2/152 Nursing (miscellaneous), 6/114 Geriatrics and Gerontology, 9/259 Health Policy, 139/2844 Medicine (miscellaneous) No data IDR 2018 UEM |
| Databáze: | OpenAIRE |
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