The electronic frailty index and outcomes in patients with myocardial infarction.
Humans
Female
Male
Aged
Myocardial Infarction
/ mortality
Aged, 80 and over
Retrospective Studies
Frailty
/ diagnosis
Geriatric Assessment
/ methods
Frail Elderly
/ statistics & numerical data
Risk Assessment
/ methods
Registries
Risk Factors
Hospitalization
/ statistics & numerical data
Cause of Death
electronic frailty index
frailty
myocardial infarction
older people
routine data
Journal
Age and ageing
ISSN: 1468-2834
Titre abrégé: Age Ageing
Pays: England
ID NLM: 0375655
Informations de publication
Date de publication:
02 Jul 2024
02 Jul 2024
Historique:
received:
16
01
2024
accepted:
03
07
2024
medline:
16
7
2024
pubmed:
16
7
2024
entrez:
16
7
2024
Statut:
ppublish
Résumé
Frailty is increasingly present in patients with acute myocardial infarction. The electronic Frailty Index (eFI) is a validated method of identifying vulnerable older patients in the community from routine primary care data. Our aim was to assess the relationship between the eFI and outcomes in older patients hospitalised with acute myocardial infarction. Retrospective cohort study using the DataLoch Heart Disease Registry comprising consecutive patients aged 65 years or over hospitalised with a myocardial infarction between October 2013 and March 2021. Patients were classified as fit, mild, moderate, or severely frail based on their eFI score. Cox-regression analysis was used to determine the association between frailty category and all-cause mortality. In 4670 patients (median age 77 years [71-84], 43% female), 1865 (40%) were classified as fit, with 1699 (36%), 798 (17%) and 308 (7%) classified as mild, moderate and severely frail, respectively. In total, 1142 patients died within 12 months of which 248 (13%) and 147 (48%) were classified as fit and severely frail, respectively. After adjustment, any degree of frailty was associated with an increased risk of all-cause death with the risk greatest in the severely frail (reference = fit, adjusted hazard ratio 2.87 [95% confidence intervals 2.24 to 3.66]). The eFI identified patients at high risk of death following myocardial infarction. Automatic calculation within administrative data is feasible and could provide a low-cost method of identifying vulnerable older patients on hospital presentation.
Sections du résumé
BACKGROUND
BACKGROUND
Frailty is increasingly present in patients with acute myocardial infarction. The electronic Frailty Index (eFI) is a validated method of identifying vulnerable older patients in the community from routine primary care data. Our aim was to assess the relationship between the eFI and outcomes in older patients hospitalised with acute myocardial infarction.
STUDY DESIGN AND SETTING
METHODS
Retrospective cohort study using the DataLoch Heart Disease Registry comprising consecutive patients aged 65 years or over hospitalised with a myocardial infarction between October 2013 and March 2021.
METHODS
METHODS
Patients were classified as fit, mild, moderate, or severely frail based on their eFI score. Cox-regression analysis was used to determine the association between frailty category and all-cause mortality.
RESULTS
RESULTS
In 4670 patients (median age 77 years [71-84], 43% female), 1865 (40%) were classified as fit, with 1699 (36%), 798 (17%) and 308 (7%) classified as mild, moderate and severely frail, respectively. In total, 1142 patients died within 12 months of which 248 (13%) and 147 (48%) were classified as fit and severely frail, respectively. After adjustment, any degree of frailty was associated with an increased risk of all-cause death with the risk greatest in the severely frail (reference = fit, adjusted hazard ratio 2.87 [95% confidence intervals 2.24 to 3.66]).
CONCLUSION
CONCLUSIONS
The eFI identified patients at high risk of death following myocardial infarction. Automatic calculation within administrative data is feasible and could provide a low-cost method of identifying vulnerable older patients on hospital presentation.
Identifiants
pubmed: 39011637
pii: 7714052
doi: 10.1093/ageing/afae150
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Subventions
Organisme : Research Excellence Awards
ID : RE/18/5/34216
Organisme : Programme Grant
ID : RG/20/10/34966 and RG/F/22/110093
Organisme : British Heart Foundation through Chair
ID : CH/F/21/90010 and CH/09/002
Organisme : Clinical Research Training Fellowship
ID : MR/V007017/1
Organisme : British Heart Foundation Clinical Research Training Fellowship
ID : FS/CRTF/21/2473
Organisme : British Heart Foundation Intermediate Basic Science Research Fellowship
ID : FS/IBSRF/23/25161
Organisme : Clinical Research Training Fellowships from the Medical Research Council
ID : MR/W000598/1
Informations de copyright
© The Author(s) 2024. Published by Oxford University Press on behalf of the British Geriatrics Society.