PREVALENCE OF PRE-FRAILTY AND FRAILTY IN PATIENTS WITH MULTIVESSEL CORONARY ARTERY DISEASE

Abstract

Highlights The article is focused on one of the most urgent modern issues – the peculiarities of the diagnosis of pathological aging. Due to the absence of a “gold standard” of detection of frailty, attempts to assess its prevalence among the population of different age groups present fragmented and controversial data. In this study, for the first time, the prevalence of frailty in patients with multivessel coronary artery disease, characterized by extremely pronounced clinical complexity, was analyzed using six different diagnostic approaches, allowing us to obtain data on the sensitivity and specificity of these instruments. AbstractAim. To study the prevalence of pre-frailty and frailty in patients with multivessel coronary artery disease.Methods. The study included 387 patients with multivessel coronary artery disease scheduled for coronary artery bypass grafting. To detect pre-frailty and frailty, we have used various diagnostic approaches, such as the screening questionnaire “Age is not a drawback”, a multi-stage diagnostic framework based on the clinical recommendations on frailty developed by the “Russian Association of Gerontologists and Geriatricians” in 2020, the questionnaire “PRISMA-7”, the clinical frailty scale, the criteria of the Fried frailty phenotype, and the modified 5-item frailty index (mFI-5).Results. The median age was 65 [59; 69] years, men were the majority (73.1%). Taking into account six diagnostic approaches, the prevalence of frailty in patients with multivessel coronary artery disease varied from 19.1% to 71.6%, the prevalence of pre-frailty varied from 15% to 58.2%. A high number of patients with frailty was detected using a multi-stage diagnostic framework based on the on the clinical recommendations on frailty developed by the “Russian Association of Gerontologists and Geriatricians” (46.8%), the clinical frailty scale (44.5%), the criteria of the Fried frailty phenotype (42.4%) and mFI-5 (71.6%), the lowest number of patients with frailty was detected using the questionnaire “PRISMA-7” (22.5%). The clinical frailty scale showed a higher level of sensitivity and specificity (67.8% and 80%, respectively) regarding the detection of pre-frailty, whereas a multi-stage diagnostic framework had a higher level of sensitivity and specificity (65.2% and 76.8%, respectively) regarding the detection of frailty.Conclusions. The results of the study revealed a high prevalence of pre-frailty (15–58.2%) and frailty (19.1–71.6%) in patients with multivessel coronary artery disease, taking into account several diagnostic approaches. The clinical frailty scale and a multi-stage diagnostic framework based on the recommendations showed the highest sensitivity and specificity regarding the detection of frailty (clinical frailty scale – 67.8% and 80%, respectively; a multi-stage diagnostic framework – 65.2% and 76.8%, respectively).