Abstract
BackgroundElderly patients represent a large proportion of patients admitted for acute coronary syndrome (ACS). Whether frailty—defined as a biological syndrome that reflects a state of decreased physiological reserve and vulnerability to stressors—may impact the clinical outcomes in this population remains unclear. We aimed to determine the prevalence of frailty and its impact on mortality in patients aged ≥ 80 years admitted for ACS. MethodsThis prospective observational study was conducted in patients aged 80 years or older admitted to a tertiary hospital for ACS. Frailty was assessed using the Edmonton Frail Scale (EFS), which provides a score ranging from 0 (not frail) to 17 (very frail). The population was divided into 3 classes: EFS score 0-3, EFS score 4-6; and EFS score >7. ResultsTwo hundred thirty-six patients were included, with a mean follow-up duration of 470 days. The mean age was 85.9 years. Seventy-five patients died during the follow-up period. One hundred nineteen patients (50.4%) had an EFS score of 0-3, 68 patients (28.8%) had an EFS score of 4-6, and 49 patients (20.8%) had an EFS score ≥ 7. The all-cause mortality rate was 17.7% in the EFS 0-3 group, 35.3% in the EFS 4-6 group, and 61.2% in the EFS ≥ 7 group (P < 0.001). After multivariate analysis, frailty status remained associated with all-cause mortality: the hazard ratio (HR) was 1.53 (95% confidence interval [CI], 0.74-3.16) in the EFS 4-6 group, and the HR was 3.60 (95% CI, 1.70-7.63) in the EFS ≥ 7 group. ConclusionsFrailty is a strong and independent prognostic factor for midterm all-cause mortality in elderly patients presenting with ACS.
Published Version
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