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

Journal of Geriatric Cardiology 2023年第3期20卷 174-184页

作者： Wojciech Nowak ilona kowalik Michał Nowicki Tomasz Cichocki Janina Stępińska Department of Intensive Cardiac Therapy National Institute of CardiologyWarsawPoland Clinical Research Support Center National Institute of CardiologyWarsawPoland Department of Coronary Artery Disease and Cardiac Rehabilitation National Institute of CardiologyWarsawPoland

BACKGROUND Acute coronary syndrome(ACS)is linked to a range of in-hospital complications,and age is recognized as risk factor for adverse *** between physiological and chronological age are explained by ***,the relationship between frailty and in-hospital complications is not *** Assessment of frailty in patients was carried out using the FRAIL ***-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 ***:45.5%vs.16.7%,P3 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

关键词： patients complications coronary

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Comparison of the prognostic value of frailty assessment tools in patients aged≥65 years hospitalized in a cardiac care unit with acute coronary syndrome

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Journal of Geriatric Cardiology 2022年第5期19卷 343-353页

作者： Wojciech Nowak ilona kowalik Małgorzata Kuzin Agnieszka Krauze Anna Mierzyńska Ewa Sadowy Kamil Marcinkiewicz Janina Stępińska Department of Intensive Cardiac Therapy National Institute of CardiologyWarsawPoland Clinical Research Support Center National Institute of CardiologyWarsawPoland Department of Coronary Artery Disease and Cardiac Rehabilitation National Institute of CardiologyWarsawPoland

BACKGROUND Frailty is associated with adverse events in elderly patients with acute coronary syndrome(ACS).Our aim was to compare the prognostic value of four frailty scales in patients aged≥65 years hospitalized with ACS in a cardiac care unit(CCU).METHODS Patients aged≥65 years with ACS were *** was assessed using the Fried frailty scale(reference standard),the Edmonton Frail Scale(EFS),the FRAIL scale,and the Clinical frailty scale(CFS).The primary end point was all-cause mortality and the secondary end point was unscheduled *** One hundred and seventy four patients aged≥65 years with ACS were *** median follow-up was 637.5 *** was identified in 41.4%,40.2%,39.1%and 36.3%patients by the Fried frailty scale,EFS,FRAIL scale and CFS,*** agreement coefficients were 0.88,0.86,and 0.79 for the FRAIL scale,EFS and CFS,*** the Cox regres-sion model,frailty was associated with all-cause mortality regardless of the scale used(univariate:hazard ratio[HR]95%CI=10.5,2.4-46.8 Fried frailty scale;12.0,2.7-53.4 FRAIL scale;7.1,2.0-25.2 EFS;8.3,2.4-29.6 ***:HR=5.1,1.1-23.8 Fried frailty scale;5.7,1.2-26.8 FRAIL scale;3.7,1.0-14.0 EFS;4.2,1.1-15.9 CFS).The FRAIL scale had the highest *** the uni-variate analysis,frailty was associated with unscheduled rehospitalization(HR=3.2,1.7-6.0 Fried frailty scale;3.4,1.8-6.3 FRAIL scale;3.5,1.8-6.6 EFS;3.1,1.7-5.8 CFS).In the multivariate analysis,only the EFS independently predicted unscheduled rehospit-alization(HR=2.2,1.1-4.63).CONCLUSIONS Frailty assessed by the Fried frailty scale,FRAIL scale,EFS and CFS is associated with all-cause mortality and unscheduled rehospitalization in elderly patients hospitalized in a CCU with *** adjusted HR of the FRAIL scale for all-cause mortality was the highest among the scales compared,whereas the EFS was an independent predictor of unscheduled *** data should be taken into consider

关键词： patients mortality coronary

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