Kwok, C ORCID: https://orcid.org/0000-0001-7047-1586, Achenbach, S, Curzen, N, Fischman, D, Savage, M, Bagur, R, Kontopantelis, E, Martin, G, Steg, PG and Mamas, M ORCID: https://orcid.org/0000-0001-9241-8890 (2019) Relation of Frailty to Outcomes in Percutaneous Coronary Intervention. Cardiovascular Revascularization Medicine.

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Abstract

There is growing awareness that frailty may be an important marker of adverse outcomes in PCI but there is no literature from national cohorts. This study examines a national cohort of patients who underwent percutaneous coronary intervention (PCI) regarding the prevalence of frailty, changes over time, and associated outcomes. The National Inpatients Sample was used to identify adults who underwent PCI procedures between 2004 and 2014. Frailty risk was measured using a validated Hospital Frailty Risk Score (HFRS) using the cutoffs <5, 5-15 and >15 for low, intermediate and high HFRS. From 7,306,007 admissions, a total of 94.58% of admissions were for patients who had a low HFRS(<5), 5.39% had an intermediate HFRS(5-15) and 0.03% had a high HFRS(>15). The prevalence of intermediate or high frailty risk patients has increased over time from 1.9% in 2004 to 11.7% in 2014. The incidence of in-hospital death increased from 1.0% with low HFRS to 13.9% with high HFRS. Mean length of stay also increased from 2.9 days to 17.1 days from low to high HFRS. High frailty risk was independently associated with an OR 9.91 95%CI 7.17-13.71 for in-hospital death, OR 4.99 95%CI 3.82-6.51 for bleeding complications and OR 3.96 95%CI 3.00-5.23 for vascular complications as compared to patients with low risk of HFRS. While rare in frequency overall, frailty is increasing in prevalence in recent years and intermediate and high HFRS associated with increased odds of mortality compared to low risk of frailty.

Item Type: Article
Additional Information: This is the accepted author manuscript (AAM). The final published version (version of record) is available online via Elsevier at https://doi.org/10.1016/j.carrev.2019.11.009 - please refer to any applicable terms of use of the publisher.
Uncontrolled Keywords: frailty, percutaneous coronary intervention, mortality, complications
Subjects: R Medicine > RC Internal medicine > RC666 Diseases of the circulatory (Cardiovascular) system
Divisions: Faculty of Medicine and Health Sciences > Primary Care Health Sciences
Depositing User: Symplectic
Date Deposited: 07 Nov 2019 15:31
Last Modified: 22 Nov 2019 15:06
URI: https://eprints.keele.ac.uk/id/eprint/7154

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