Impact of the clinical frailty scale on mid-term mortality in patients with ST-elevated myocardial infarction

Abstract

Background “Frailty” is associated with poor prognosis in ST-elevated myocardial infarction (STEMI). However, there is little data regarding the impact of the Canadian Study of Health and Aging Clinical Frailty Scale (CFS), a simple and semiquantitative tool for assessing frailty, on mid-term mortality in STEMI patients. Methods A total of 354 consecutive STEMI patients (mean age 69.8 ± 12.4 years; male 76.6%) who underwent percutaneous intervention between July 2014 and March 2017 were retrospectively reviewed. The study endpoint was mid-term mortality according to the CFS classification. Furthermore, in order to clarify the impact of CFS upon admission on mid-term mortality, the independent predictors of all-cause death were evaluated. Results Patients were categorized into three groups (CFS 1–3, n = 281; CFS 4–5, n = 62; and CFS 6–7, n = 11). During the study period (median 474 days), all-cause death was observed in 39 patients. After multivariate Cox regression analysis, higher CFS (adjusted hazard ratio [HR] 2.34, 95% confidence interval [CI] 1.43–3.85, p < 0.001), higher Killip score (adjusted HR 2.46, 95%CI 1.30–5.78, p = 0.002), and lower serum albumin level (adjusted HR 4.29, 95%CI 2.16–8.51, p < 0.001) were significantly associated with an increased risk of all-cause death. Conclusion In conclusion, severe frailty was associated with mid-term mortality in STEMI patients who underwent PCI.

Hospital readmission and mortality: associations to a hospital frailty risk score in a national sample of US older adults with pre-existing coronary heart disease, an observational study.

“…As expected, in our sample of older adults with pre-existing CHD our findings showed increased mortality as the rates and risk of frailty increase. These results are similar to those in CVD [12,16,25], acute coronary syndrome [31][32][33], and myocardial infarction [34], as well as after CVD interventions [35][36][37]. This lends credence to using the HFRS for observational research, or for applications with electronic medical records (EMR) to identify frailty using ICD-10-CM codes to determine who may be at greater risk for readmission or death.…”

Correlation Analysis of Hemoglobin-to-Red Blood Cell Distribution Width Ratio and Frailty in Elderly Patients With Coronary Heart Disease

“…Studies have shown that frailty is an independent risk factor for the accelerated development of agerelated diseases in patients with CHD (5). Yoshioka et al (6) have found that intermediate mortality in patients with ST-segment myocardial infarction is associated with frailty. Frailty can be reversed with intervention, especially in the early stages (7).…”

Frailty Scores and Their Utility in Older Patients with Cardiovascular Disease

“…An association between severe frailty and mid-term mortality was also observed in STEMI patients undergoing PCI. [ 57 ] In that study, 3.1% of the 354 patients were frail according to the CFS (≥6), and this was identified as an independent predictor of mid-term all-cause mortality (adjusted HR 2.46; 95% CI [1.52–3.98]), together with higher Killip score (adjusted HR 3.10; 95% CI [1.50–6.39]) and lower serum albumin concentrations (adjusted HR 4.29; 95% CI [2.16–8.51]).…”