Relation of frailty to outcomes in percutaneous coronary intervention

Kwok CS, Achenbach S, Curzen N, Fischman DL, Savage M, Bagur R, Kontopantelis E, Martin GP, Steg PG, Mamas MA (2019)

Publication Type: Journal article

Publication year: 2019

Journal

Cardiovascular Revascularization Medicine Elsevier

DOI: 10.1016/j.carrev.2019.11.009

Abstract

There is growing awareness that frailty may be an important marker of adverse outcomes in PCI but there is no literature from national cohorts. This study examines a national cohort of patients who underwent percutaneous coronary intervention (PCI) regarding the prevalence of frailty, changes over time, and associated outcomes. The National Inpatients Sample was used to identify adults who underwent PCI procedures between 2004 and 2014. Frailty risk was measured using a validated Hospital Frailty Risk Score (HFRS) using the cutoffs <5, 5–15 and >15 for low, intermediate and high HFRS. From 7,306,007 admissions, a total of 94.58% of admissions were for patients who had a low HFRS(<5), 5.39% had an intermediate HFRS(5–15) and 0.03% had a high HFRS(>15). The prevalence of intermediate or high frailty risk patients has increased over time from 1.9% in 2004 to 11.7% in 2014. The incidence of in-hospital death increased from 1.0% with low HFRS to 13.9% with high HFRS. Mean length of stay also increased from 2.9 days to 17.1 days from low to high HFRS. High frailty risk was independently associated with an OR 9.91 95%CI 7.17–13.71 for in-hospital death, OR 4.99 95%CI 3.82–6.51 for bleeding and OR 3.96 95%CI 3.00–5.23 for vascular injury as compared to patients with low risk of HFRS. While rare in frequency overall, frailty is increasing in prevalence in recent years and intermediate and high HFRS associated with increased odds of mortality compared to low risk of frailty.

Authors with CRIS profile

Stephan Achenbach Lehrstuhl für Innere Medizin II

Involved external institutions

Thomas Jefferson University Hospitals US United States (USA) (US) University of Southampton GB United Kingdom (GB) University of Keele GB United Kingdom (GB) National Institute for Health and Medical Research / Institut national de la santé et de la recherche médicale (INSERM) FR France (FR) University of Manchester GB United Kingdom (GB)

How to cite

APA:

Kwok, C.S., Achenbach, S., Curzen, N., Fischman, D.L., Savage, M., Bagur, R.,... Mamas, M.A. (2019). Relation of frailty to outcomes in percutaneous coronary intervention. Cardiovascular Revascularization Medicine. https://doi.org/10.1016/j.carrev.2019.11.009

MLA:

Kwok, Chun Shing, et al. "Relation of frailty to outcomes in percutaneous coronary intervention." Cardiovascular Revascularization Medicine (2019).

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