The Impact of Frailty on Mortality, Length of Stay and Re-hospitalisation in Older Patients with Atrial Fibrillation

Abstract

Frailty has been found to be associated with increased adverse outcomes in older patients, especially in patients with cardiovascular diseases. There has been no study focussing on the prognostic value of frailty amongst older hospitalised patients with atrial fibrillation. This study aims to investigate the impact of frailty on mortality, length of stay and re-hospitalisation in older hospitalised patients with atrial fibrillation. Prospective observational study in patients aged ≥65 years with atrial fibrillation admitted to a teaching hospital in Sydney, Australia. Frailty was assessed using the Reported Edmonton Frail Scale. Participants were followed up for six months for adverse outcomes. We recruited 302 patients (mean age 84.7±7.1, 53.3% frail, 50% female). Frailty was associated with prolonged length of stay and increased mortality but not re-admission during six months after discharge. The coexistence of frailty and delirium significantly increased the risk of mortality. Frailty is a common geriatric syndrome in older inpatients with atrial fibrillation and is associated with poor outcomes. Screening for frailty along with other clinically important factors like delirium should be considered in older patients with atrial fibrillation to optimise individualised treatment plans.