Clinical Interventions in Aging (Dec 2023)

Association of Frailty with Adverse Outcomes in Patients with Critical Acute Myocardial Infarction: A Retrospective Cohort Study

  • Bai W,
  • Huang T,
  • Li X,
  • Gao W,
  • Qin J,
  • Bian Y,
  • Xu W,
  • Xu J,
  • Qin L

Journal volume & issue
Vol. Volume 18
pp. 2129 – 2139

Abstract

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Weimin Bai,1,* Taoke Huang,2,* Xinying Li,3,* Weiyang Gao,2 Ji Qin,2 Yongxin Bian,4 Weihao Xu,5 Juan Xu,6 Lijie Qin1 1Department of Emergency, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, People’s Hospital of Henan University, Zhengzhou, 463599, People’s Republic of China; 2Medical School of Chinese PLA, Beijing, 100853, People’s Republic of China; 3Faculty of Postgraduate Education, Shandong Sport University, Jinan, 250102, People’s Republic of China; 4The First School of Clinical Medicine, Binzhou Medical University, Yantai, 264003, People’s Republic of China; 5Haikou Cadre’s Sanitarium of Hainan Military Region, Haikou, 570203, People’s Republic of China; 6Department of General Surgery, Affiliated Xiaoshan Hospital, Hangzhou Normal University, Hangzhou, 311202, People’s Republic of China*These authors contributed equally to this workCorrespondence: Juan Xu; Lijie Qin, Email [email protected]; [email protected]: Frailty is a risk factor for acute myocardial infarction (AMI). This study examined the association between the modified frailty index (MFI) and adverse outcomes in patients with critical AMI.Methods: Data were obtained from the Medical Information Mart for Intensive Care IV database. Logistic and Cox regression models and a competing risk model were applied.Results: Of 5003 patients, 1496 were non-frail and 3507 were frail. Frailty was significantly associated with in-hospital mortality (per point, OR 1.13, 95% CI: 1.05– 1.21; frail vs non-frail, OR 1.31, 95% CI: 1.04– 1.65) and 1-year mortality (per point, HR 1.15, 95% CI: 1.11– 1.20; frail vs non-frail, HR 1.37, 95% CI: 1.20– 1.58). Frailty was significantly associated with post-discharge care needs (per point, OR 1.23, 95% CI: 1.14– 1.33; frail vs non-frail, OR 1.47, 95% CI: 1.22– 1.78). In the competing risk models, frailty was significantly associated with a lower probability of being discharged from the ICU (per point, HR 0.87, 95% CI: 0.85– 0.90; frail vs non-frail, HR 0.73, 95% CI: 0.68– 0.79) and hospital (per point, HR 0.82, 95% CI: 0.80– 0.85; frail vs non-frail, HR 0.62, 95% CI: 0.57– 0.68). Subgroup analyses showed the association of frailty with in-hospital and 1-year mortality was stronger in patients with a SOFA score ≤ 2 than in those with a SOFA score > 2 (both p< 0.05 for interaction).Conclusion: Frailty assessed by the MFI was an independent predictor of adverse outcomes in patients with critical AMI and may be helpful for prognostic risk stratification.Keywords: frailty, modified frailty index, acute myocardial infarction, critically ill patients, prognosis

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