Frailty for predicting all-cause mortality in elderly acute coronary syndrome patients: A meta-analysis

Man, Changfeng; Xiang, Shouyan; Fan, Yu

doi:10.1016/j.arr.2019.03.003

Cited by 23 publications

(17 citation statements)

References 29 publications

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“…In a previous study, SA level was particularly noteworthy as an indicator for frailty that was associated with adverse outcomes. Man et al [ 24 ] reported a 2- to 5-fold higher risk of in-hospital, short-, and long-term mortality in elderly patients with acute coronary syndrome. Changes in SA levels have also been associated with changes in cachectic factors.…”

Section: Discussionmentioning

confidence: 99%

Prognostic value of serum albumin-to-creatinine ratio in patients with acute myocardial infarction

Liu

Zhang

et al. 2020

Medicine

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The long-term association between serum albumin-to-creatinine ratio (sACR) and poor patient outcomes in acute myocardial infarction (AMI) remains unclear. This study aimed to determine whether sACR was a predictor of poor long-term survival in patients with AMI. This was a study of patients with AMI in the emergency department (ED) from the retrospective multicenter study for early evaluation of acute chest pain (REACP) study. The patients were categorized into tertiles (T1, T2, and T3) based on the admission sACR (0.445 and 0.584 g/μmol). Baseline sACR at admission to the ED was predictive of adverse outcomes. The primary outcome was all-cause mortality within the follow-up period. Cox proportional hazards models were performed to investigate the association between sACR and all-cause mortality in patients with AMI. A total of 2250 patients with AMI were enrolled, of whom 229 (10.2%) died within the median follow-up period of 10.7 (7.2–14.6) months. Patients with a lower sACR had higher all-cause mortality and adverse outcomes rates than patients with a higher sACR. Kaplan–Meier survival analysis showed that patients with a higher sACR had a higher cumulative survival rate ( P < .001). Cox regression analysis showed that a decreased sACR was an independent predictor of all-cause mortality [T2 vs T1: hazard ratio (HR); 0.550, 95% confidence interval (95% CI), 0.348–0.867; P = .010 and T3 vs T1: HR, 0.305; 95% CI, 0.165–0.561; P < .001] and cardiac mortality (T2 vs T1: HR, 0.536; 95% CI, 0.332–0.866; P = .011 and T3 vs T1: HR, 0.309; 95% CI, 0.164–0.582, P < .001). The sACR at admission to ED was independently associated with adverse outcomes, indicating that baseline sACR was a useful biomarker to identify high-risk patients with AMI at an early phase in ED.

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Section: Discussionmentioning

confidence: 99%

Prognostic value of serum albumin-to-creatinine ratio in patients with acute myocardial infarction

Liu

Zhang

et al. 2020

Medicine

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“…It classifies patients as robust (score 1-3), pre-frail (score 4), and frail (score >5) (Dent et al, 2019). This stratification allowed to identify not only frail individuals, who usually have higher risk of serious health complications and worse prognosis; but pre-frail subjects as well, who have reported an increased risk of negative events, such as an elevated mortality from all causes (Changfeng, Shouyan & Yu, 2019).…”

Section: Frailty Assessmentmentioning

confidence: 99%

“…Stratifying patients according to their level of frailty is key to determine the risks to which they are exposed (Changfeng, Shouyan & Yu, 2019). Currently, a gold standard instrument for assessing frailty is lacking; however, the International Conference of Frailty and Sarcopenia Research Task Force recommends using a validated setting-specific instrument to screen frail elderly adults (Dent et al, 2019;Hoogendijk et al, 2019), such as the Clinical Frailty Scale (CFS).…”

Section: Introductionmentioning

confidence: 99%

Outcomes of hospitalized patients with COVID-19 according to level of frailty

Andrés-Esteban

Quintana-Díaz

Ramírez-Cervantes

et al. 2021

PeerJ

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Background The complications from coronavirus disease 2019 (COVID-19) have been the subject of study in diverse scientific reports. However, many aspects that influence the prognosis of the disease are still unknown, such as frailty, which inherently reduces resistance to disease and makes people more vulnerable. This study aimed to explore the complications of COVID-19 in patients admitted to a third-level hospital and to evaluate the relationship between these complications and frailty. Methods An observational, descriptive, prospective study was performed in 2020. A sample of 254 patients from a database of 3,112 patients admitted to a high-level hospital in Madrid, Spain was analyzed. To assess frailty (independent variable) the Clinical Frailty Scale (CFS) was used. The outcome variables were sociodemographic and clinical, which included complications, length of stay, intensive care unit (ICU) admission and prognosis. Results A total of 13.39% of the patients were pre-frail and 17.32% were frail. Frail individuals had a shorter hospital stay, less ICU admission, higher mortality and delirium, with statistical significance. Conclusion Frailty assessment is a crucial approach in patients with COVID-19, given a higher mortality rate has been demonstrated amongst frail patients. The CFS could be a predictor of mortality in COVID-19.

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“…In addition to investigation into social support and frailty, our study further demonstrated that frailty was predictive of mortality in older people, which was consistently observed in an abundant number of previous studies. [16][17][18][19][20] Possible explanation could be that frailty denoted a multidimensional accumulation of health deficits and vulnerability to stressors, which could act as a precursor to functional limitation, falls, hospitalisation, poor quality of life, and eventually mortality. 14,15 Most previous studies failed to distinguish the differences in distinct sources of social support.…”

Section: Discussionmentioning

confidence: 99%

“…Frailty, defined as a multidimensional measure of vulnerability assessing the generalized decline of individuals and a good proxy for biological aging, 14,15 has been increasingly recognized in gerontological research and literature as a strong predictor for detrimental health outcomes including mortality. [16][17][18][19][20] Moreover, a growing body of research proposed that frailty syndrome could be aggravated due to lack of social support, even though such evidence was currently concentrated in developed countries. For instance, presence of social support was previously found to be linked to reduced frailty in Germany, 21 Austrian, 22 and Korean 23 populations.…”

Section: Introductionmentioning

confidence: 99%

Social Support and Mortality in Community-Dwelling Chinese Older Adults: The Mediating Role of Frailty

Fan¹,

Wang²,

Xue³

et al. 2021

RMHP

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Purpose Population ageing is posing an unprecedented challenge globally, necessitating a better understanding of modifiable factors and underlying pathways that could contribute to health and longevity in older age. We thus aim to investigate how the modifiable social support (and its various sources) is related to mortality among older adults, as well as whether and to what extent geriatric frailty plays a role in mediating the relationship. Methods We included 11,934 community-dwelling adults (≥65) from four waves of the Chinese Longitudinal Healthy Longevity Survey (2008–2018). Frailty was constructed by 44 health deficits, following a validated frailty index scale. Social support was measured using a sum score of three dimensions (family support, social service and social security) with 22 items. The outcome was all-cause mortality. Multivariate logistic or linear regression models were employed when appropriate to assess the associations among social support, frailty and mortality. Mediation analysis was applied to examine the role of frailty underlying the pathway between social support and mortality risk. Results A higher sum score of social support at baseline reduced mortality risk during the 10-year follow-up period (AOR=0.947, 95% CI=0.917~0.977). Amongst three sources of social support, family support and social security availability showed significantly protective effect against mortality, while social service revealed only non-significant effect. A higher level in the overall social support (β=−0.066, 95% CI=−0.113~-0.020) or family support (β=−0.121, 95% CI=−0.202~-0.039) was also significantly associated with decreased frailty. Meanwhile, frailty partially mediated the relationship of mortality with the overall social support and family support, where the proportion of mediation equaled to 17.1% and 20.5%, respectively. Conclusion Social support could be associated with reduced risks for frailty and mortality, and such protective influences are especially manifested in its family support component among Chinese older adults. Frailty functions as potential mediator underlying the association of mortality with social support and family support. Our findings indicate the importance of social support as an integral part of geriatric care and underline the potential benefits of frailty assessment and intervention.

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Frailty for predicting all-cause mortality in elderly acute coronary syndrome patients: A meta-analysis

Cited by 23 publications

References 29 publications

Prognostic value of serum albumin-to-creatinine ratio in patients with acute myocardial infarction

Prognostic value of serum albumin-to-creatinine ratio in patients with acute myocardial infarction

Outcomes of hospitalized patients with COVID-19 according to level of frailty

Social Support and Mortality in Community-Dwelling Chinese Older Adults: The Mediating Role of Frailty

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