Clinical medicine (London, England)
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Identifying older people with clinical frailty, reliably and at scale, is a research priority. We measured frailty in older people using a novel methodology coding frailty syndromes on routinely collected administrative data, developed on a national English secondary care population, and explored its performance of predicting inpatient mortality and long length of stay at a single acute hospital. ⋯ Coded frailty syndromes significantly predict outcomes. Model diagnostics suggest the model could be used for screening of elderly patients to optimise their care.
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A 31-year-old man presented with central chest heaviness. He was a smoker of 15 pack-years, but otherwise had no other comorbidities. He was also a professional footballer. ⋯ Unfortunately, there remains a lack of evidence to help guide treatment decisions. Furthermore, there are no known guidelines on managing coronary anomalies in athletes, such as the case presented. As the majority of national guidelines have largely recommended CTCA as first-line investigation in patients with low to intermediate risk of CAD with chest pain, incidental finding of coronary anomalies will become more common, urging the need for guidelines to help with directing management in such cases.