Prediction study of frailty index on adverse events in elderly patients with coronary heart disease six months after discharge
Objective This study aims to explore the predictive value of the frailty index on adverse events in elderly patients with coronary heart disease six months after discharge.Methods A total of 184 elderly patients diagnosed with coronary heart disease were included in the study from January 2020 to January 2022.The patients were divided into two groups:a non-frail group and a frail group,according to their Fried frailty criteria.The follow-up period lasted for 6 months after discharge.The rehospitalization rate,all-cause mortality,acute myocardial infarction,and major bleeding events were recorded through outpatient and inpatient records and telephone interviews.Results A total of 96 patients were classified as frail(52.17%)with a frailty index of(0.68±0.12),while 88 patients were non-frail(47.83%)with a frailty index of(0.14±0.02).There were no significant differences in age,gender,BMI,smoking history,drinking history,hypertension,diabetes,and coronary heart disease between the two groups(P>0.05).However,there was a significant difference in heart function between the two groups,with 96 patients in the frail group(2%in classⅠ,60.4%in classⅡ,27.1%in classⅢ,and 10.4%in classⅣ)and 88 patients in the non-frail group(13.6%in classⅠ,62.5%in classⅡ,20.5%in classⅢ,and 3.4%in classⅣ)(χ2=5.863,P=0.017).There were no significant differences in the incidence of common complications between the two groups(P>0.05).During the 6-month follow-up period,9 patients(9.38%)in the frail group developed recurrent acute myocardial infarction,4 patients(4.17%)developed major bleeding,and 8 patients(8.33%)died.In the non-frail group,3 patients(3.12%)were rehospitalized due to recurrent acute myocardial infarction or major bleeding events,with a significant difference between the two groups(χ2=4.990,P=0.019).Logistic regression analysis showed that the frailty index was an independent predictor of rehospitalization,all-cause mortality,acute myocardial infarction,and major bleeding events within 6 months in elderly patients with coronary heart disease(P<0.05).Conclusion The frailty index is significantly associated with rehospitalization,all-cause mortality,acute myocardial infarction,and major bleeding events within 6 months in elderly patients with coronary heart disease and serves as an independent predictor for these outcomes.Therefore,it is important to identify and manage frailty in elderly patients with coronary heart disease after discharge from the hospital to provide targeted interventions such as rehabilitation training and nutritional support to improve overall health and quality of life.
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