Is frailty associated with short-term outcomes for elderly patients with acute coronary syndrome？  

作　　者：Lin KANG Shu-Yang ZHANG Wen-Ling ZHU Hai-Yu PANG Li ZHANG Ming-Lei ZHU Xiao-Hong LIU Yong-Tai LIU 

机构地区：[1]Geriatrics Department, Peking Union Medical College Hospital, Beijing, China [2]Cardiology Department, Peking Union Medical College Hospital, Beijing, China [3]Central Research Lab, Peking Union Medical College Hospital Beijing, China [4]Clinical laboratory, Peking Union Medical College Hospital Beijing, China

出　　处：《Journal of Geriatric Cardiology》2015年第6期662-667,共6页老年心脏病学杂志（英文版）

摘　　要：Background Frailty is a new prognostic factor in cardiovascular medicine due to the aging and increasingly complex nature of elderly patients. It is useful and meaningful to prospectively analyze the manner in which frailty predicts short-term outcomes for elderly patients with acute coronary syndrome （ACS）. Methods Patients aged 〉 65 years, with diagnosis of ACS from cardiology department and geriatrics department were included from single-center. Clinical data including geriatrics syndromes were collected using Comprehensive Geriatrics Assessment. Frailty was defined according to the Clinical Frailty Scale and the impact of the co-morbidities on risk was quantified by the coronary artery disease （CAD）--specific index. Patients were followed up by clinical visit or telephone consultation and the median follow-up time is 120 days. Following-up items included all-cause mortality, unscheduled return visit, in-hospital and recurrent major adverse cardiovascular events. Multivariable regression survival analysis was performed using Cox regression. Results Of the 352 patients, 152 （43.18%） were considered frail according to the study instrument （5-7 on the scale）, and 93 （26.42%） were considered moderately or se- verely frail （6-7 on the scale）. Geriatrics syndromes including incontinence, fall history, visual impairment, hearing impairment, constipation, chronic pain, sleeping disorder, dental problems, anxiety or depression, and delirium were more frequently in frail patients than in non-frail patients （P = 0.000, 0.031, 0.009, 0.014, 0.000, 0.003, 0.022, 0.000, 0.074, and 0.432, respectively）. Adjusted for sex, age, severity of coro- nary artery diseases （left main coronary artery lesion or not） and co-morbidities （CAD specific index） by Cox survival analysis, frailty was found to be strongly and independently associated with risk for the primary composite outcomes： all-canse mortality [Hazard Ratio （HR） = 5.393; 95% CI： 1.477-19.692, P = 0.011] and unscheduled return v

关 键 词：Acute coronary syndrome Comprehensive Geriatrics Assessment FRAILTY Survival analysis Unscheduled return visit 

分 类 号：O212[理学—概率论与数理统计] Q51[理学—数学]