Pre-existing Frailty Linked with Worse Clinical Outcome in Older Adults with Acute MI

They further used multivariable logistic regression to examine the association between assigned frailty by score or scale and in-hospital mortality.

Key findings of the study:

• Among 143,722 older AMI patients, the researchers observed 108,059 (75.2%) were fit/well and 6,484 (4.5%) were vulnerable to frailty, while 7,527 (5.2%) had mild, 3,913 (2.7%) had moderate, 2,715 had (1.9%) severe, and 632 (0.4%) had very severe frailty according to the ACTION Frailty Scale, while 14,392 (10.0%) could not be categorized due to incomplete ascertainment.
• They noted that frail patients were older, more frequently female, of non-white race/ethnicity, and less likely to be treated with guideline-recommended therapies.
• They found that increasing severity of frailty by this scale was associated with a step-wise higher risk for in-hospital mortality.
• They also found that patient categories of the ACTION Frailty Score provided similar results
• After adjustment, they noted that each 1-unit increase in Frailty Score was associated with a 12% higher mortality risk (OR 1.12).

The authors concluded, "Among older patients with acute myocardial infarction, frailty is common and independently associated with in-hospital mortality. These findings show the importance of pragmatic evaluation of frailty in hospital-level quality scores, guideline recommendations, and incorporation into other registry data collection efforts."

For further information:

DOI: https://doi.org/10.1016/j.ahj.2022.03.007

Keywords: Acute myocardial infarction, NCDR ACTION Registry, frailty, older adults, aged, myocardial infarction, function, Clinical outcomes, coronary heart disease, American Heart Journal