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Frailty assessment can help predict PCI outcomes
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A frailty assessment can help predict mortality and length of hospital stay after PCI, according to study data published in Open Heart.
“Frailty assessment has emerged as a measure of biological age and has been shown to better correlate with outcomes. Frailty assessment can, therefore, not only provide additional prognostic information, complementing conventional risk scores, but also guide health care providers to plan PCI and appropriate resources for frail patients,” Javaid Iqbal, MD, PhD, interventional cardiologist, Northern General Hospital, Sheffield, England, told Cardiology Today.
Javaid Iqbal
Iqbal and colleagues evaluated demographic, clinical and angiographic data of 745 patients (mean age, 62 years; 70% men) undergoing PCI between March 2012 and March 2014 at the South Yorkshire Cardiothoracic Centre in Sheffield to determine whether frailty predicted the length of hospital stay and mortality post-PCI.
The patients were assessed for frailty at the time of the procedure using the Canadian Study of Health and Aging Clinical Frailty Scale of 1 (very fit) to 9 (terminally ill). The mean frailty score was 3 ± 1.3, and 81 patients were classified as “frail,” with a score of 5 to 9. Frail patients tended to be older and female, and also more likely to have comorbid conditions, including lower left ventricular ejection fraction, peripheral vascular disease, history of congestive HF, renal impairment, diabetes, high BP and previous stroke.
From admission to discharge after PCI, frail patients remained in the hospital longer (mean length of stay, 14.1 ± 26.7 days vs. 3.5 ± 8.8 days; P < .001). Mortality rates were higher for frail patients at 30 days (4.9% vs. 1.1%; HR = 4.8; 95% CI, 1.4-16.3) and at 1 year (11.1% vs. 1.9%; HR = 5.9; 95% CI, 2.5-13.8).
Researchers cited limitations to the study, including the inclusion of only patients undergoing PCI, potential exclusion of frail patients not being referred for invention and the somewhat subjective nature of the frailty assessment. – by Trish Shea, MA
Disclosure: The researchers report no relevant financial disclosures.
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