• J Am Med Dir Assoc · Apr 2018

    Multicenter Study

    An Easy Assessment of Frailty at Baseline Independently Predicts Prognosis in Very Elderly Patients With Acute Coronary Syndromes.

    • Oriol Alegre, Francesc Formiga, Ramón López-Palop, Francisco Marín, María T Vidán, Manuel Martínez-Sellés, Antoni Carol, Alessandro Sionis, Pablo Díez-Villanueva, Jaime Aboal, Anna Palau-Vendrel, Héctor Bueno, Angel Perez Rivera, Juan Sanchís, Emad Abu-Assi, Miguel Corbí, Juan C Castillo, Jordi Bañeras, Violeta González-Salvado, Àngel Cequier, Albert Ariza-Solé, and LONGEVO-SCA registry investigators.
    • Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain.
    • J Am Med Dir Assoc. 2018 Apr 1; 19 (4): 296-303.

    BackgroundInformation about the impact of frailty in patients with acute coronary syndromes (ACS) is scarce. No study has assessed the prognostic impact of frailty as measured by the FRAIL scale in very elderly patients with ACS.MethodsThe prospective multicenter LONGEVO-SCA registry included unselected patients with ACS aged 80 years or older. A comprehensive geriatric assessment was performed during hospitalization, including frailty assessment by the FRAIL scale. The primary endpoint was mortality at 6 months.ResultsA total of 532 patients were included. Mean age was 84.3 years, 61.7% male. Most patients had positive troponin levels (84%) and high GRACE risk score values (mean 165). A total of 205 patients were classified as prefrail (38.5%) and 145 as frail (27.3%). Frail and prefrail patients had a higher prevalence of comorbidities, lower left ventricle ejection fraction, and higher mean GRACE score value. A total of 63 patients (11.8%) were dead at 6 months. Both prefrailty and frailty were associated with higher 6-month mortality rates (P < .001). After adjusting for potential confounders, this association remained significant (hazard ratio [HR] 2.71; 95% confidence interval [CI] 1.09-6.73 for prefrailty and HR 2.99; 95% CI 1.20-7.44 for frailty, P = .024). The other independent predictors of mortality were age, Charlson Index, and GRACE risk score.ConclusionsThe FRAIL scale is a simple tool that independently predicts mortality in unselected very elderly patients with ACS. The presence of prefrailty criteria also should be taken into account when performing risk stratification of these patients.Copyright © 2017 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

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