Frailty Scales for Prognosis Assessment of Older Adult Patients after Acute Myocardial Infarction
Sergio García‐Blas, Clara Bonanad, Agustín Fernández‐Cisnal, C Sastre-Arbona, María-Arántzazu Ruescas-Nicolau, Jessika González, Ernesto Valero, Gema Miñana, Patricia Palau, Francisco José Tarazona‐Santabalbina, Vicente Ruiz Ros, Julio Núñez, Juan Sanchís
Abstract
We aimed to compare the prognostic value of two different measures, the Fried’s Frailty Scale (FFS) and the Clinical Frailty Scale (CFS), following myocardial infarction (MI). We included 150 patients ≥ 70 years admitted from AMI. Frailty was evaluated on the day before discharge. The primary endpoint was number of days alive and out of hospital (DAOH) during the first 800 days. Secondary endpoints were mortality and a composite of mortality and reinfarction. Frailty was diagnosed in 58% and 34% of patients using the FFS and CFS scales, respectively. During the first 800 days 34 deaths and 137 admissions occurred. The number of DAOH decreased significantly with increasing scores of both FFS (p < 0.001) and CFS (p = 0.049). In multivariate analysis, only the highest scores (FFS = 5, CFS ≥ 6) were independently associated with fewer DAOH. At a median follow-up of 946 days, frailty assessed both by FFS and CFS was independently associated with death and MI (HR = 2.70 95%CI = 1.32–5.51 p = 0.001; HR = 2.01 95%CI = 1.1–3.66 p = 0.023, respectively), whereas all-cause mortality was only associated with FFS (HR = 1.51 95%CI = 1.08–2.10 p = 0.015). Frailty by FFS or CFS is independently associated with shorter number DAOH post-MI. Likewise, frailty assessed by either scale is associated with a higher rate of death and reinfarction, whereas FFS outperforms CFS for mortality prediction.