Journal of Multidisciplinary Healthcare (May 2023)

The Frail Scale – A Risk Stratification in Older Patients with Acute Coronary Syndrome

  • Pham HM,
  • Nguyen AP,
  • Nguyen HTT,
  • Nguyen TN,
  • Nguyen TX,
  • Nguyen TTH,
  • Nguyen HTT,
  • Nguyen AT,
  • Nguyen QN,
  • Tran GS,
  • Vu HTT

Journal volume & issue
Vol. Volume 16
pp. 1521 – 1529

Abstract

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Hung Manh Pham,1,2 Anh Phuong Nguyen,1,2 Huong Thi Thu Nguyen,3,4 Tam Ngoc Nguyen,3,4 Thanh Xuan Nguyen,3,4 Thu Thi Hoai Nguyen,3,4 Huong Thi Thanh Nguyen,5,6 Anh Trung Nguyen,3,4 Quang Ngoc Nguyen,1,2 Giang Song Tran,1 Huyen Thi Thanh Vu3,4 1Vietnam National Heart Institute, Bach Mai Hospital, Hanoi, 100000, Vietnam; 2Department of Cardiology, Hanoi Medical University, Hanoi, 100000, Vietnam; 3Department of Geriatrics, Hanoi Medical University, Hanoi, 100000, Vietnam; 4Scientific Research Department, National Geriatric Hospital, Hanoi, 100000, Vietnam; 5Physiology Department, Hanoi Medical University, Hanoi, 100000, Vietnam; 6Dinh Tien Hoang Institute of Medicine, Hanoi, 100000, VietnamCorrespondence: Anh Phuong Nguyen, Vietnam National Heart Institute, Bach Mai Hospital, Hanoi, 100000, Vietnam, Tel +84 989314464, Email [email protected]: The aim of this study was to explore the impact of frailty on in-hospital adverse outcomes and net adverse clinical events (NACE) in older patients with acute coronary syndrome.Patients and Methods: This observational study included elderly patients (≥ 60 years old), diagnosed with acute coronary syndrome (ACS) at admission from February 2021 to August 2021. The primary outcome was net adverse clinical events (NACE) defined as a composite of all-cause mortality, stroke, and major bleeding. Secondary outcome was in-hospital adverse outcomes including arrhythmia, acquired pneumonia, stroke, major bleeding, and all-cause mortality. Frailty was assessed using the Frail scale (FS). Data about socio-demographics, comorbidities, body mass index, ACS type, coronary angiography, left ventricular ejection fraction, and length of hospital stay were also collected. Univariate and multivariate logistic regressions were employed to identify the potential association between frailty and outcomes.Results: Of the 116 ACS patients, 38 patients were frail (32.76%). Frail subjects were more often female (50%) and older (p < 0.01) and had higher rates of in-hospital adverse outcomes (OR = 2.37, p = 0.05) and NACE (OR = 7.12; p < 0.01). In univariate analysis, the increased frail score was significantly associated with increased odds of NACE (unadjusted OR = 1.98, 95% CI 1.17– 3.35 for each score increase in Frail Score). In multivariable logistic regression, models controlling for age, gender, PCI, LVEF, and coronary angiography (adjusted OR 2.19, 95% CI 1.12– 4.29 for each score increase in Frail Score).Conclusion: This study revealed the reference data of frailty assessment in older patients with ACS in Vietnam. Our result indicated that over 30% of ACS older patients presented with frailty which was associated with an increased risk of in-hospital adverse outcomes and NACE. This study also provided promising information about the simple FRAIL scale’s potential role in the risk stratification of older patients with ACS.Keywords: Frail scale, elderly, acute coronary syndrome

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