The impact of frailty on in-hospital complications in elderly patients with acute coronary syndrome  

作　　者：Wojciech Nowak Ilona Kowalik Michał Nowicki Tomasz Cichocki Janina Stępińska 

机构地区：[1]Department of Intensive Cardiac Therapy,National Institute of Cardiology,Warsaw,Poland [2]Clinical Research Support Center,National Institute of Cardiology,Warsaw,Poland [3]Department of Coronary Artery Disease and Cardiac Rehabilitation,National Institute of Cardiology,Warsaw,Poland

出　　处：《Journal of Geriatric Cardiology》2023年第3期174-184,共11页老年心脏病学杂志（英文版）

摘　　要：BACKGROUND Acute coronary syndrome(ACS)is linked to a range of in-hospital complications,and age is recognized as risk factor for adverse events.Discrepancies between physiological and chronological age are explained by frailty.However,the relationship between frailty and in-hospital complications is not clear.METHODS Assessment of frailty in patients was carried out using the FRAIL scale.In-hospital complications assessed included,bleeding,infection,arrhythmia,acute kidney injury(AKI),delirium,stroke/transient ischemic attack(TIA),liver injury,hypoglycemia,length of stay in the cardiac care unit(CCU).RESULTS Of the 174 patients,frailty was identified in 39.1%and pre-frailty in 29.9%.Frailty was associated with a higher incidence of all types of bleeding(frail vs.robust:45.5%vs.16.7%,P<0.001)and infection(54.4%vs.11.1%,P<0.001),including pneumonia/lower respiratory tract infections(LRTI)and urinary tract infections(UTI).Incidence of antibiotic therapy(52.9%vs.13.0%,P<0.001),atrial fibrillation(AF)(47.1%vs.9.3%,P<0.001),AKI(57.3%vs.20.4%,P<0.001),delirium(52.9%vs.3.7%,P<0.001),liver injury,were higher in frail patients(17.6%vs.0,P=0.001),whilst their length of stay in the CCU was longer(4 days(2-6.5)vs.2 days(2-3),P<0.001).Infections,pneumonia/LRTI,antibiotic therapy during hospitalization,the incidence of AF and liver injury were more often in patients with pre-frailty compared to the robust group.After adjustment for potential confounders,frailty remained independently associated with an increased risk of infection(OR:3.3[1.6-7.0]),including pneumonia/LRTI(OR:2.5[1.1-5.8])and UTI(OR:4.8[1.8-12.5]).Frail individuals had an increased requirement for antibiotic therapy(OR:3.9[1.9-8.1]),and greater risk of AF(OR:3.5[1.3-9.3]),AKI(OR:2.6[1.2-5.3])delirium(OR:11.7[4.8-28.7]),as well as having to stay longer in the CCU(>3 days)(OR:3.7[1.9-7.3]).CONCLUSIONS Frailty was associated with an increased risk of numerous in-hospital complications in elderly patients who had been hospitalized with ACS.

关 键 词：PATIENTS COMPLICATIONS CORONARY 

分 类 号：R541.4[医药卫生—心血管疾病]