Frailty and Outcome in Elderly Patients With Acute Coronary Syndrome

Graham, Michelle M.; Galbraith, P. Diane; Oneill, D.M.; Rolfson, Darryl; Dando, Candace; Norris, Colleen M.

doi:10.1016/j.cjca.2013.08.016

Cited by 112 publications

(108 citation statements)

References 30 publications

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“…23 In this setting frailty ranged from 10% to 48%, and higher levels of frailty were associated with worse outcomes (Table 5). 47,[49][50][51][52][53][54][55] These studies showed an independent added prognostic value of frailty assessment, and although larger studies are needed to refine risk prediction models, it is suggested that clinicians and researchers should consider how they can embed frailty measurement into clinical practice.…”

Section: Frailty In Cardiologymentioning

confidence: 99%

“…The prevalence of frailty and its clinical and prognostic relevance has not as yet been well characterised in the environment of CR, although many studies have reported the measurement of frailty in patients with coronary syndromes in intensive care units or in cardiology wards, [49][50][51][52] and others have underscored the close link between frailty and CHF. [71][72][73][74][75][76][77][78][79][80] As patients after ACS or CHF represent a considerable proportion of those participating in CR, 85,86 we may suggest that frailty measurement should be performed in CR, to help plan their management and estimate their prognosis.…”

Section: Frailty and Crmentioning

confidence: 99%

“…23 The EFS is easy to administer, requiring less than 5 minutes to perform; it can be administered by any professional (nurse, technician) or student, and it has been validated in elderly patients after acute coronary syndromes, 49 where it was found to correlate with prognosis. It also includes two clinical performance items interrogating cognition (clock test) and functional performance (timed up and go -TUG test).…”

Section: Future Directionsmentioning

confidence: 99%

See 2 more Smart Citations

Frailty and cardiac rehabilitation: A call to action from the EAPC Cardiac Rehabilitation Section

Vigorito

Abreu

Ambrosetti³

et al. 2016

Eur J Prev Cardiolog

165

133

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Frailty is a geriatric syndrome characterised by a vulnerability status associated with declining function of multiple physiological systems and loss of physiological reserves. Two main models of frailty have been advanced: the phenotypic model (primary frailty) or deficits accumulation model (secondary frailty), and different instruments have been proposed and validated to measure frailty. However measured, frailty correlates to medical outcomes in the elderly, and has been shown to have prognostic value for patients in different clinical settings, such as in patients with coronary artery disease, after cardiac surgery or transvalvular aortic valve replacement, in patients with chronic heart failure or after left ventricular assist device implantation. The prevalence, clinical and prognostic relevance of frailty in a cardiac rehabilitation setting has not yet been well characterised, despite the increasing frequency of elderly patients in cardiac rehabilitation, where frailty is likely to influence the onset, type and intensity of the exercise training programme and the design of tailored rehabilitative interventions for these patients. Therefore, we need to start looking for frailty in elderly patients entering cardiac rehabilitation programmes and become more familiar with some of the tools to recognise and evaluate the severity of this condition. Furthermore, we need to better understand whether exercise-based cardiac rehabilitation may change the course and the prognosis of frailty in cardiovascular patients.

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Section: Frailty In Cardiologymentioning

confidence: 99%

Section: Frailty and Crmentioning

confidence: 99%

Section: Future Directionsmentioning

confidence: 99%

See 1 more Smart Citation

Frailty and cardiac rehabilitation: A call to action from the EAPC Cardiac Rehabilitation Section

Vigorito

Abreu

Ambrosetti³

et al. 2016

Eur J Prev Cardiolog

165

133

View full text Add to dashboard Cite

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“…These data are similar to the results of a study conducted with elderly individuals of the community, in which females presented with the highest level of frailty, evaluated using the EFS, and other studies conducted in an international context with frailty evaluated based on the frailty phenotype proposed by Fried, and the proposed Frailty Index by Rockwood. (25)(26)(27) The greater prevalence of frailty in women is due to their living longer, being economically dependent, and influenced by conditions marked by sexual issues, and having a restricted social life. (28) In the present research, the prevalence of frailty can be verified in the interviewed elderly.…”

Section: Cras -Social Assistance In Referral Centersmentioning

confidence: 99%

Fragilidade de idosos em vulnerabilidade social

et al. 2017

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Objective: To identify the relationship between frailty, sociodemographic characteristics, and social vulnerability of the elderly enrolled in a primary care service. Methods: This was an exploratory, comparative, and cross-sectional study with a quantitative research approach performed with 247 elderly people enrolled in a primary care service, in a city in the interior of São Paulo. A questionnaire was used for socio-demographic characterization of the participants, and the Edmonton Frail Scale was used to evaluate frailty. Vulnerability was classified according to the Paulista Index of Social Vulnerability. Data were analyzed in a descriptive and inferential manner. All ethical recommendations were met. Results: There was a prevalence of frail elderly women, with a mean age of 68.5 (SD=7.3) years, low education, who were retirees. There was a statistically significant difference between frailty and the number of diseases reported (p<0.001). Frailty correlated negatively with social vulnerability (r=-0.043). Conclusion: These results should receive attention from public administrators to understand frailty of the elderly in a context of social vulnerability. ResumoObjetivo: Identificar a relação entre fragilidade, características sociodemográficos e vulnerabilidade social de idosos cadastrados em um serviço de atendimento primário. Métodos: Trata-se de um estudo exploratório, comparativo e transversal, com abordagem quantitativa de investigação realizado com 247 idosos cadastrados em um serviço de atendimento primário, em um município do interior paulista. Utilizou-se questionário para caracterização sócio demográfica dos participantes e Escala de Fragilidade de Edmonton, para avaliar a fragilidade. A vulnerabilidade foi classificada segundo Índice Paulista de Vulnerabilidade Social. Os dados foram analisados de forma descritiva e inferencial. Todas as recomendações éticas foram respeitadas. Resultados: Houve prevalência de idosos frágeis pertencentes ao gênero feminino, com média de idade de 68,5 (dp=7,3) anos, baixa escolaridade e aposentados. Houve diferença estatisticamente significativa entre fragilidade e número de doenças relatadas (p<0,001). A fragilidade se correlacionou negativamente com a vulnerabilidade social (r=-0,043). Conclusão: Os resultados encontrados devem suscitar atenção aos gestores públicos para a necessidade de conhecer a fragilidade de idosos em contexto de vulnerabilidade social.

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“…The researches have also shown that fatigue and weakness in elderly patients after open heart surgery decreases physical activity and functionality level of the patients. Reduced functionality level, which is among common complications after open heart surgery, can reduce the patients' independence and increase their dependence on the family members and relatives (7).…”

Section: Introductionmentioning

confidence: 99%

Depression, Functionality and Adaptability of Elderly Patients After Open Heart Surgery Off- or On-Pump

Asgari

Bahramnezhad

Mehrdad

et al. 2015

Jundishapur J Chronic Dis Care

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Background:Open heart surgery is performed by two methods of off or on cardiopulmonary bypass. Both methods may affect the rate of depression, level of functionality and adaptation of the elderly undergoing the operations. Objectives: The current study aimed to assess depression, level of functionality and adaptability in elderly patients undergoing open heart surgery with off or on pump in the in open heart surgery intensive care unit of Imam Khomeini and Shariati Hospitals, Tehran University of Medical Sciences. Patients and Methods:This cross-sectional study was conducted from 23 September 2013 to 22 March 2014. The samples were 160 elderly patients who were selected by convenience sampling method and divided into two groups of on-and off-pump coronary artery bypass graft. The rate of depression and level of functionality of the patients were assessed before and six weeks after surgery by Geriatric Depression Scale (GDS) and Medical Outcome Study SF 12 (MOS SF-12) questionnaires respectively, in a self-reporting approach. The rate of patient's adaptability was also evaluated six weeks after the surgery by Ways of Coping Questionnaire (WOCQ). Results: In on-and off-pump groups, there were statistically significant differences in terms of depression rate and level of functionality before and six weeks after the surgery, respectively, as (P = 0.001) and (P = 0.0001). The t-test results also showed that the patients' adapt ability in the on-pump group with the mean ± SD of 111.1 ± 56.17 was significantly different from that of the off-pump group with the average changes of 70.88 ± 91.15 (P = 0.0001). Conclusions: It is recommended to further support the patients undergoing on-pump open heart surgery, and some programs will be designed to reduce the level of their depression and increase their adaptability and functionality levels.

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Frailty and Outcome in Elderly Patients With Acute Coronary Syndrome

Cited by 112 publications

References 30 publications

Frailty and cardiac rehabilitation: A call to action from the EAPC Cardiac Rehabilitation Section

Frailty and cardiac rehabilitation: A call to action from the EAPC Cardiac Rehabilitation Section

Fragilidade de idosos em vulnerabilidade social

Depression, Functionality and Adaptability of Elderly Patients After Open Heart Surgery Off- or On-Pump

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