학술논문
Frailty to predict unplanned hospitalization, stroke, bleeding, and death in atrial fibrillation
ORIGINAL ARTICLE
ORIGINAL ARTICLE
Document Type
Clinical report
Author
Gugganig, Rebecca; Aeschbacher, Stefanie; Leong, Darryl P.; Meyre, Pascal; Blum, Steffen; Coslovsky, Michael; Beer, JUrg H.; Moschovitis, Giorgio; MUller, Dominic; Anker, Daniela; Rodondi, Nicolas; Stempfel, Samuel; Mueller, Christian; Meyer-Zurn, Christine; Kuhne, Michael; Conen, David; Osswald, Stefan
Source
European Heart Journal: Quality of Care and Clinical Outcomes. January 2021, Vol. 7 Issue 1, p42, 10 p.
Subject
Language
English
ISSN
2058-5225
Abstract
Introduction Frailty is a common condition in geriatric patients, characterized by a reduced biological reserve and high vulnerability to adverse outcomes including death. (1) Depending on the assessment tool and [...]
Aims Atrial fibrillation (AF) and frailty are common, and the prevalence is expected to rise further. We aimed to investigate the prevalence of frailty and the ability of a frailty index (FI) to predict unplanned hospitalizations, stroke, bleeding, and death in patients with AF. Methods Patients with known AF were enrolled in a prospective cohort study in Switzerland. Information on medical and results history, lifestyle factors, and clinical measurements were obtained. The primary outcome was unplanned hospitalization; secondary outcomes were all-cause mortality, bleeding, and stroke. The FI was measured using a cumulative deficit approach, constructed according to previously published criteria and divided into three groups (non-frail, pre-frail, and frail). The association between frailty and outcomes was assessed using multivariable-adjusted Cox regression models. Of the 2369 included patients, prevalence of pre-frailty and frailty was 60.7% and 10.6%, respectively. Pre-frailty and frailty were associated with a higher risk of unplanned hospitalizations [adjusted hazard ratio (aHR) 1.82, 95% confidence interval (CI) 1.49-2.22; P< 0.001; and aHR 3.59, 95% CI 2.78-4.63, P Conclusion Over two-thirds of patients with AF are pre-frail or frail. These patients have a high risk for unplanned hospitalizations and other adverse events. These findings emphasize the need to carefully evaluate these patients. However, whether screening for pre-frailty and frailty and targeted prevention strategies improve outcomes needs to be shown in future studies. Clinical trial Clinicaltrials.gov identifier number: NCT02105844. registration Keywords Atrial fibrillation * Elderly * Frailty * Hospitalization * Mortality
Aims Atrial fibrillation (AF) and frailty are common, and the prevalence is expected to rise further. We aimed to investigate the prevalence of frailty and the ability of a frailty index (FI) to predict unplanned hospitalizations, stroke, bleeding, and death in patients with AF. Methods Patients with known AF were enrolled in a prospective cohort study in Switzerland. Information on medical and results history, lifestyle factors, and clinical measurements were obtained. The primary outcome was unplanned hospitalization; secondary outcomes were all-cause mortality, bleeding, and stroke. The FI was measured using a cumulative deficit approach, constructed according to previously published criteria and divided into three groups (non-frail, pre-frail, and frail). The association between frailty and outcomes was assessed using multivariable-adjusted Cox regression models. Of the 2369 included patients, prevalence of pre-frailty and frailty was 60.7% and 10.6%, respectively. Pre-frailty and frailty were associated with a higher risk of unplanned hospitalizations [adjusted hazard ratio (aHR) 1.82, 95% confidence interval (CI) 1.49-2.22; P< 0.001; and aHR 3.59, 95% CI 2.78-4.63, P Conclusion Over two-thirds of patients with AF are pre-frail or frail. These patients have a high risk for unplanned hospitalizations and other adverse events. These findings emphasize the need to carefully evaluate these patients. However, whether screening for pre-frailty and frailty and targeted prevention strategies improve outcomes needs to be shown in future studies. Clinical trial Clinicaltrials.gov identifier number: NCT02105844. registration Keywords Atrial fibrillation * Elderly * Frailty * Hospitalization * Mortality