Prognosis impact of frailty assessed by the Edmonton Frail Scale in the setting of acute coronary syndrome in the elderly
Abstract Background Elderly patients represent a large proportion of patients admitted for Acute Coronary Syndrome (ACS). Whether frailty, defined as a biological syndrome that reflects a state of decreased physiological reserve and vulnerability to stressors, may impact the clinical outcomes in thi...
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| Veröffentlicht in: | Canadian journal of cardiology 2017-07, Vol.33 (7), p.933-939 |
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| creator | Blanco, Stéphanie, MD Ferrières, Jean, MD, PhD Bongard, Vanina, MD, PhD Toulza, Olivier, MD Sebai, Fatia Billet, Sophie Biendel, Caroline, MD Lairez, Olivier, MD, PhD Lhermusier, Thibault, MD, PhD Boudou, Nicolas, MD Campelo-Parada, Francisco, MD Roncalli, Jérôme, MD, PhD Galinier, Michel, MD, PhD Carrié, Didier, MD, PhD Elbaz, Meyer, MD, PhD Bouisset, Frédéric, MD |
| description | Abstract Background Elderly patients represent a large proportion of patients admitted for Acute Coronary Syndrome (ACS). Whether frailty, defined as a biological syndrome that reflects a state of decreased physiological reserve and vulnerability to stressors, may impact the clinical outcomes in this population remains unclear. We aimed to determine the prevalence of frailty and its impact on mortality in patients aged ≥ 80 years admitted for ACS. Methods This prospective observational study was conducted among patients aged 80 or older admitted in a tertiary hospital for ACS. Frailty was assessed using the Edmonton Frail Scale (EFS) which provides a score ranging from 0 (not frail) to 17 (very frail). Population was divided into 3 classes: [0-3] EFS-score, [4-6] EFS-score, and [>7] EFS-score. Results 236 patients were included with a mean follow-up duration of 470 days. The mean age was 85.9 years. 75 patients died during follow-up period.119 subjects (50.4%) had a [0-3] EFS-score, 68 patients (28.8%) had a [4-6] EFS-score and 49 patients (20.8%) had a [ ≥ 7] EFS-score. All-cause mortality rate was 17.7% in the [0-3] EFS-score group, 35.3% in the [4-6] EFS-score group and 61.2% in the [ ≥ 7] EFS-score group, (p |
| doi_str_mv | 10.1016/j.cjca.2017.03.026 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1915557178</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0828282X17301782</els_id><sourcerecordid>1915557178</sourcerecordid><originalsourceid>FETCH-LOGICAL-c477t-d29bd7daa851c7b60bf6bd27e08629e5ffbb3af7253f7372ae6da35b7f28e2203</originalsourceid><addsrcrecordid>eNp9kU1rFTEUhgdR7LX6B1xIlm5mzMedJBdEkNKqUFCogruQSU5qxpnkmmQK8-_NeGsXLoTAWeR5XzjPaZqXBHcEE_5m7MxodEcxER1mHab8UbMjB8JbgUX_uNlhSWVLJf1-1jzLecR4T4TgT5szKjmXZM92zfolxdsQs8_Iz0dtCooOuaT9VFakc4b6LBpWVH4AurRzDCUGdLUB6MboCZAPf_4ylOLD7RbXZimATEwx6LSivAab4vxAwmQhTevz5onTU4YX9_O8-XZ1-fXiY3v9-cOni_fXrdkLUVpLD4MVVmvZEyMGjgfHB0sFYMnpAXrnhoFpJ2jPnGCCauBWs34QjkqgFLPz5vWp95jirwVyUbPPBqZJB4hLVlVY3_eCCFlRekJNijkncOqY_Fx3UASrTbka1aZcbcoVZqoqr6FX9_3LMIN9iPx1XIG3JwDqlnceksrGQzBgfQJTlI3-__3v_ombyQdf3f-EFfIYlxSqP0VUpgqrm-3o282JYLVFUvYb1T6pWw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1915557178</pqid></control><display><type>article</type><title>Prognosis impact of frailty assessed by the Edmonton Frail Scale in the setting of acute coronary syndrome in the elderly</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals Complete</source><creator>Blanco, Stéphanie, MD ; Ferrières, Jean, MD, PhD ; Bongard, Vanina, MD, PhD ; Toulza, Olivier, MD ; Sebai, Fatia ; Billet, Sophie ; Biendel, Caroline, MD ; Lairez, Olivier, MD, PhD ; Lhermusier, Thibault, MD, PhD ; Boudou, Nicolas, MD ; Campelo-Parada, Francisco, MD ; Roncalli, Jérôme, MD, PhD ; Galinier, Michel, MD, PhD ; Carrié, Didier, MD, PhD ; Elbaz, Meyer, MD, PhD ; Bouisset, Frédéric, MD</creator><creatorcontrib>Blanco, Stéphanie, MD ; Ferrières, Jean, MD, PhD ; Bongard, Vanina, MD, PhD ; Toulza, Olivier, MD ; Sebai, Fatia ; Billet, Sophie ; Biendel, Caroline, MD ; Lairez, Olivier, MD, PhD ; Lhermusier, Thibault, MD, PhD ; Boudou, Nicolas, MD ; Campelo-Parada, Francisco, MD ; Roncalli, Jérôme, MD, PhD ; Galinier, Michel, MD, PhD ; Carrié, Didier, MD, PhD ; Elbaz, Meyer, MD, PhD ; Bouisset, Frédéric, MD</creatorcontrib><description>Abstract Background Elderly patients represent a large proportion of patients admitted for Acute Coronary Syndrome (ACS). Whether frailty, defined as a biological syndrome that reflects a state of decreased physiological reserve and vulnerability to stressors, may impact the clinical outcomes in this population remains unclear. We aimed to determine the prevalence of frailty and its impact on mortality in patients aged ≥ 80 years admitted for ACS. Methods This prospective observational study was conducted among patients aged 80 or older admitted in a tertiary hospital for ACS. Frailty was assessed using the Edmonton Frail Scale (EFS) which provides a score ranging from 0 (not frail) to 17 (very frail). Population was divided into 3 classes: [0-3] EFS-score, [4-6] EFS-score, and [>7] EFS-score. Results 236 patients were included with a mean follow-up duration of 470 days. The mean age was 85.9 years. 75 patients died during follow-up period.119 subjects (50.4%) had a [0-3] EFS-score, 68 patients (28.8%) had a [4-6] EFS-score and 49 patients (20.8%) had a [ ≥ 7] EFS-score. All-cause mortality rate was 17.7% in the [0-3] EFS-score group, 35.3% in the [4-6] EFS-score group and 61.2% in the [ ≥ 7] EFS-score group, (p<0.001). After multivariate analysis, frailty status remained associated with all-cause mortality: HR was 1.53 (95% CI [0.74 - 3.16]) within the [4-6] EFS-score group, and HR was 3.60 (95% CI [1.70 - 7.63]) within the [ ≥ 7] EFS-score group. Conclusion Frailty is a strong and independent prognosis factor of midterm all-cause mortality in elderly patients presenting with ACS.</description><identifier>ISSN: 0828-282X</identifier><identifier>EISSN: 1916-7075</identifier><identifier>DOI: 10.1016/j.cjca.2017.03.026</identifier><identifier>PMID: 28668143</identifier><language>eng</language><publisher>England: Elsevier Inc</publisher><subject>Acute Coronary Syndrome - diagnosis ; Acute Coronary Syndrome - epidemiology ; Aged, 80 and over ; Cardiovascular ; Cause of Death - trends ; Female ; Follow-Up Studies ; Frail Elderly - statistics & numerical data ; France - epidemiology ; Geriatric Assessment - methods ; Humans ; Male ; Prevalence ; Prognosis ; Prospective Studies ; Survival Rate - trends</subject><ispartof>Canadian journal of cardiology, 2017-07, Vol.33 (7), p.933-939</ispartof><rights>2017 Canadian Cardiovascular Society</rights><rights>Copyright © 2017 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c477t-d29bd7daa851c7b60bf6bd27e08629e5ffbb3af7253f7372ae6da35b7f28e2203</citedby><cites>FETCH-LOGICAL-c477t-d29bd7daa851c7b60bf6bd27e08629e5ffbb3af7253f7372ae6da35b7f28e2203</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0828282X17301782$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65534</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28668143$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Blanco, Stéphanie, MD</creatorcontrib><creatorcontrib>Ferrières, Jean, MD, PhD</creatorcontrib><creatorcontrib>Bongard, Vanina, MD, PhD</creatorcontrib><creatorcontrib>Toulza, Olivier, MD</creatorcontrib><creatorcontrib>Sebai, Fatia</creatorcontrib><creatorcontrib>Billet, Sophie</creatorcontrib><creatorcontrib>Biendel, Caroline, MD</creatorcontrib><creatorcontrib>Lairez, Olivier, MD, PhD</creatorcontrib><creatorcontrib>Lhermusier, Thibault, MD, PhD</creatorcontrib><creatorcontrib>Boudou, Nicolas, MD</creatorcontrib><creatorcontrib>Campelo-Parada, Francisco, MD</creatorcontrib><creatorcontrib>Roncalli, Jérôme, MD, PhD</creatorcontrib><creatorcontrib>Galinier, Michel, MD, PhD</creatorcontrib><creatorcontrib>Carrié, Didier, MD, PhD</creatorcontrib><creatorcontrib>Elbaz, Meyer, MD, PhD</creatorcontrib><creatorcontrib>Bouisset, Frédéric, MD</creatorcontrib><title>Prognosis impact of frailty assessed by the Edmonton Frail Scale in the setting of acute coronary syndrome in the elderly</title><title>Canadian journal of cardiology</title><addtitle>Can J Cardiol</addtitle><description>Abstract Background Elderly patients represent a large proportion of patients admitted for Acute Coronary Syndrome (ACS). Whether frailty, defined as a biological syndrome that reflects a state of decreased physiological reserve and vulnerability to stressors, may impact the clinical outcomes in this population remains unclear. We aimed to determine the prevalence of frailty and its impact on mortality in patients aged ≥ 80 years admitted for ACS. Methods This prospective observational study was conducted among patients aged 80 or older admitted in a tertiary hospital for ACS. Frailty was assessed using the Edmonton Frail Scale (EFS) which provides a score ranging from 0 (not frail) to 17 (very frail). Population was divided into 3 classes: [0-3] EFS-score, [4-6] EFS-score, and [>7] EFS-score. Results 236 patients were included with a mean follow-up duration of 470 days. The mean age was 85.9 years. 75 patients died during follow-up period.119 subjects (50.4%) had a [0-3] EFS-score, 68 patients (28.8%) had a [4-6] EFS-score and 49 patients (20.8%) had a [ ≥ 7] EFS-score. All-cause mortality rate was 17.7% in the [0-3] EFS-score group, 35.3% in the [4-6] EFS-score group and 61.2% in the [ ≥ 7] EFS-score group, (p<0.001). After multivariate analysis, frailty status remained associated with all-cause mortality: HR was 1.53 (95% CI [0.74 - 3.16]) within the [4-6] EFS-score group, and HR was 3.60 (95% CI [1.70 - 7.63]) within the [ ≥ 7] EFS-score group. Conclusion Frailty is a strong and independent prognosis factor of midterm all-cause mortality in elderly patients presenting with ACS.</description><subject>Acute Coronary Syndrome - diagnosis</subject><subject>Acute Coronary Syndrome - epidemiology</subject><subject>Aged, 80 and over</subject><subject>Cardiovascular</subject><subject>Cause of Death - trends</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Frail Elderly - statistics & numerical data</subject><subject>France - epidemiology</subject><subject>Geriatric Assessment - methods</subject><subject>Humans</subject><subject>Male</subject><subject>Prevalence</subject><subject>Prognosis</subject><subject>Prospective Studies</subject><subject>Survival Rate - trends</subject><issn>0828-282X</issn><issn>1916-7075</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kU1rFTEUhgdR7LX6B1xIlm5mzMedJBdEkNKqUFCogruQSU5qxpnkmmQK8-_NeGsXLoTAWeR5XzjPaZqXBHcEE_5m7MxodEcxER1mHab8UbMjB8JbgUX_uNlhSWVLJf1-1jzLecR4T4TgT5szKjmXZM92zfolxdsQs8_Iz0dtCooOuaT9VFakc4b6LBpWVH4AurRzDCUGdLUB6MboCZAPf_4ylOLD7RbXZimATEwx6LSivAab4vxAwmQhTevz5onTU4YX9_O8-XZ1-fXiY3v9-cOni_fXrdkLUVpLD4MVVmvZEyMGjgfHB0sFYMnpAXrnhoFpJ2jPnGCCauBWs34QjkqgFLPz5vWp95jirwVyUbPPBqZJB4hLVlVY3_eCCFlRekJNijkncOqY_Fx3UASrTbka1aZcbcoVZqoqr6FX9_3LMIN9iPx1XIG3JwDqlnceksrGQzBgfQJTlI3-__3v_ombyQdf3f-EFfIYlxSqP0VUpgqrm-3o282JYLVFUvYb1T6pWw</recordid><startdate>20170701</startdate><enddate>20170701</enddate><creator>Blanco, Stéphanie, MD</creator><creator>Ferrières, Jean, MD, PhD</creator><creator>Bongard, Vanina, MD, PhD</creator><creator>Toulza, Olivier, MD</creator><creator>Sebai, Fatia</creator><creator>Billet, Sophie</creator><creator>Biendel, Caroline, MD</creator><creator>Lairez, Olivier, MD, PhD</creator><creator>Lhermusier, Thibault, MD, PhD</creator><creator>Boudou, Nicolas, MD</creator><creator>Campelo-Parada, Francisco, MD</creator><creator>Roncalli, Jérôme, MD, PhD</creator><creator>Galinier, Michel, MD, PhD</creator><creator>Carrié, Didier, MD, PhD</creator><creator>Elbaz, Meyer, MD, PhD</creator><creator>Bouisset, Frédéric, MD</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20170701</creationdate><title>Prognosis impact of frailty assessed by the Edmonton Frail Scale in the setting of acute coronary syndrome in the elderly</title><author>Blanco, Stéphanie, MD ; Ferrières, Jean, MD, PhD ; Bongard, Vanina, MD, PhD ; Toulza, Olivier, MD ; Sebai, Fatia ; Billet, Sophie ; Biendel, Caroline, MD ; Lairez, Olivier, MD, PhD ; Lhermusier, Thibault, MD, PhD ; Boudou, Nicolas, MD ; Campelo-Parada, Francisco, MD ; Roncalli, Jérôme, MD, PhD ; Galinier, Michel, MD, PhD ; Carrié, Didier, MD, PhD ; Elbaz, Meyer, MD, PhD ; Bouisset, Frédéric, MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c477t-d29bd7daa851c7b60bf6bd27e08629e5ffbb3af7253f7372ae6da35b7f28e2203</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Acute Coronary Syndrome - diagnosis</topic><topic>Acute Coronary Syndrome - epidemiology</topic><topic>Aged, 80 and over</topic><topic>Cardiovascular</topic><topic>Cause of Death - trends</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Frail Elderly - statistics & numerical data</topic><topic>France - epidemiology</topic><topic>Geriatric Assessment - methods</topic><topic>Humans</topic><topic>Male</topic><topic>Prevalence</topic><topic>Prognosis</topic><topic>Prospective Studies</topic><topic>Survival Rate - trends</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Blanco, Stéphanie, MD</creatorcontrib><creatorcontrib>Ferrières, Jean, MD, PhD</creatorcontrib><creatorcontrib>Bongard, Vanina, MD, PhD</creatorcontrib><creatorcontrib>Toulza, Olivier, MD</creatorcontrib><creatorcontrib>Sebai, Fatia</creatorcontrib><creatorcontrib>Billet, Sophie</creatorcontrib><creatorcontrib>Biendel, Caroline, MD</creatorcontrib><creatorcontrib>Lairez, Olivier, MD, PhD</creatorcontrib><creatorcontrib>Lhermusier, Thibault, MD, PhD</creatorcontrib><creatorcontrib>Boudou, Nicolas, MD</creatorcontrib><creatorcontrib>Campelo-Parada, Francisco, MD</creatorcontrib><creatorcontrib>Roncalli, Jérôme, MD, PhD</creatorcontrib><creatorcontrib>Galinier, Michel, MD, PhD</creatorcontrib><creatorcontrib>Carrié, Didier, MD, PhD</creatorcontrib><creatorcontrib>Elbaz, Meyer, MD, PhD</creatorcontrib><creatorcontrib>Bouisset, Frédéric, MD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Canadian journal of cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Blanco, Stéphanie, MD</au><au>Ferrières, Jean, MD, PhD</au><au>Bongard, Vanina, MD, PhD</au><au>Toulza, Olivier, MD</au><au>Sebai, Fatia</au><au>Billet, Sophie</au><au>Biendel, Caroline, MD</au><au>Lairez, Olivier, MD, PhD</au><au>Lhermusier, Thibault, MD, PhD</au><au>Boudou, Nicolas, MD</au><au>Campelo-Parada, Francisco, MD</au><au>Roncalli, Jérôme, MD, PhD</au><au>Galinier, Michel, MD, PhD</au><au>Carrié, Didier, MD, PhD</au><au>Elbaz, Meyer, MD, PhD</au><au>Bouisset, Frédéric, MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prognosis impact of frailty assessed by the Edmonton Frail Scale in the setting of acute coronary syndrome in the elderly</atitle><jtitle>Canadian journal of cardiology</jtitle><addtitle>Can J Cardiol</addtitle><date>2017-07-01</date><risdate>2017</risdate><volume>33</volume><issue>7</issue><spage>933</spage><epage>939</epage><pages>933-939</pages><issn>0828-282X</issn><eissn>1916-7075</eissn><abstract>Abstract Background Elderly patients represent a large proportion of patients admitted for Acute Coronary Syndrome (ACS). Whether frailty, defined as a biological syndrome that reflects a state of decreased physiological reserve and vulnerability to stressors, may impact the clinical outcomes in this population remains unclear. We aimed to determine the prevalence of frailty and its impact on mortality in patients aged ≥ 80 years admitted for ACS. Methods This prospective observational study was conducted among patients aged 80 or older admitted in a tertiary hospital for ACS. Frailty was assessed using the Edmonton Frail Scale (EFS) which provides a score ranging from 0 (not frail) to 17 (very frail). Population was divided into 3 classes: [0-3] EFS-score, [4-6] EFS-score, and [>7] EFS-score. Results 236 patients were included with a mean follow-up duration of 470 days. The mean age was 85.9 years. 75 patients died during follow-up period.119 subjects (50.4%) had a [0-3] EFS-score, 68 patients (28.8%) had a [4-6] EFS-score and 49 patients (20.8%) had a [ ≥ 7] EFS-score. All-cause mortality rate was 17.7% in the [0-3] EFS-score group, 35.3% in the [4-6] EFS-score group and 61.2% in the [ ≥ 7] EFS-score group, (p<0.001). After multivariate analysis, frailty status remained associated with all-cause mortality: HR was 1.53 (95% CI [0.74 - 3.16]) within the [4-6] EFS-score group, and HR was 3.60 (95% CI [1.70 - 7.63]) within the [ ≥ 7] EFS-score group. Conclusion Frailty is a strong and independent prognosis factor of midterm all-cause mortality in elderly patients presenting with ACS.</abstract><cop>England</cop><pub>Elsevier Inc</pub><pmid>28668143</pmid><doi>10.1016/j.cjca.2017.03.026</doi><tpages>7</tpages></addata></record> |
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| ispartof | Canadian journal of cardiology, 2017-07, Vol.33 (7), p.933-939 |
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| subjects | Acute Coronary Syndrome - diagnosis Acute Coronary Syndrome - epidemiology Aged, 80 and over Cardiovascular Cause of Death - trends Female Follow-Up Studies Frail Elderly - statistics & numerical data France - epidemiology Geriatric Assessment - methods Humans Male Prevalence Prognosis Prospective Studies Survival Rate - trends |
| title | Prognosis impact of frailty assessed by the Edmonton Frail Scale in the setting of acute coronary syndrome in the elderly |
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