Email Alert RSS
Volume 12 Issue 1
Jan.  2021
Turn off MathJax
Article Contents
Abstract
References
Related Articles
ZHANG Ning, ZHU Wen-ling, LIU Xiao-hong, CHEN Wei, KANG Jun-ren, ZHU Ming-lei, TIAN Ran. Impact of Frailty on the Short-term Prognosis of Hospitalized Elderly Patients with Coronary Heart Disease:A Prospective Cohort Study[J]. Medical Journal of Peking Union Medical College Hospital, 2021, 12(1): 59-66. DOI: 10.12290/xhyxzz.20190150
Citation: ZHANG Ning, ZHU Wen-ling, LIU Xiao-hong, CHEN Wei, KANG Jun-ren, ZHU Ming-lei, TIAN Ran. Impact of Frailty on the Short-term Prognosis of Hospitalized Elderly Patients with Coronary Heart Disease:A Prospective Cohort Study[J]. Medical Journal of Peking Union Medical College Hospital, 2021, 12(1): 59-66. DOI: 10.12290/xhyxzz.20190150
shu

Impact of Frailty on the Short-term Prognosis of Hospitalized Elderly Patients with Coronary Heart Disease:A Prospective Cohort Study

  • 1.

    Department of Geriatrics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China

  • 2.

    Department of Cardiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China

  • 3.

    Department of Clinical Nutrition, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China

Funds: 

CAMS Innovation Fund for Medical Sciences 2018-I2M-1-002

More Information
  • Corresponding author:

    ZHU Wen-ling Tel: 86-10-69154063, E-mail: zhuwenling@263.net

  • Received Date: July 28, 2019
  • Accepted Date: March 23, 2020
  • Issue Publish Date: January 29, 2021
    Graphical Abstract
    • Abstract
  •   Objective  To analyze the effect of frailty on the short-term prognosis of hospitalized older patients with coronary heart disease.
      Methods  The clinical data were prospectively collected and analyzed in elderly patients with coronary heart disease that were hospitalized in Peking Union Medical College Hospital from December 2017 to November 2018. According to whether they were combined with frailty, the patients were divided into frailty group and non-frailty group.All the patients were followed up, and endpoint events included unscheduled return visits, major adverse cardiac and cerebral events (MACCE), and death from all causes. Multivariate Cox regression was used to analyze the relationship between frailty and the prognosis of patients with coronary heart disease. The Kaplan-Meier method and Log-Rank test were used to compare the MACCE-free survival curves between patients with and without frailty.
      Results  A total of 345 elderly patients with coronary heart disease who met the inclusion and exclusion criteria were selected for this study, including 250 cases of stable coronary heart disease and 95 cases of acute coronary syndrome. There were 74 cases (21.4%) in the frailty group including 38 cases of mild frailty and 36 cases of moderate frailty, and 271 cases (78.6%) in the non-frailty group. The median follow-up time was 351(300, 394) days, and 3 cases were lost to follow-up. Compared with the non-frailty group, the incidence of unscheduled return visits (36.1% vs. 21.5%) and all-cause mortality (11.1% vs. 4.1%) in the frailty group increased (all P < 0.05), and there is no significant difference in the incidence of MACCE (9.7 % vs. 4.8%) between the two groups (P > 0.05). The results of multivariate Cox regression analysis showed that mild and moderate frailty were risk factors for all causes of death in patients with stable coronary heart disease (HR=4.169, 95% CI: 1.055-16.474, P=0.042), but had no significant effect on unscheduled return visits (HR=1.704, 95% CI: 0.947-3.066, P=0.075) and MACCE (HR=1.268, 95% CI: 0.331-4.863, P=0.729). In patients with acute coronary syndrome, mild and moderate frailty had no significant effect on unscheduled return visits (HR=1.159, 95% CI: 0.342-3.924, P=0.812), MACCE (HR=0.822, 95% CI: 0.092-7.369, P=0.861) and death from all causes (HR=1.445, 95% CI: 0.210-9.964, P=0.708). The Kaplan-Meier curve showed that there was no significant in the MACCE-free survival curve between the two groups (P > 0.05).
      Conclusions  The prevalence of mild and moderate frailty in hospitalized older patients with coronary heart disease is high, which may increase the risk of short-term mortality for those with stable coronary heart disease.
    • FullText(HTML)
    • References (23)
  • [1]
    Núñez J, Palau P, Sastre C, et al. Sex-differential effect of frailty on long-term mortality in elderly patients after an acute coronary syndrome[J]. Int J Cardiol, 2020, 302: 30-33. DOI: 10.1016/j.ijcard.2019.12.068
    [2]
    陈旭娇, 严静, 王建业, 等.老年综合评估技术应用中国专家共识[J].中华老年医学杂志, 2017, 36: 471-477. DOI: 10.3760/cma.j.issn.0254-9026.2017.05.001

    Chen XJ, Yan J, Wang JY, et al. Chinese experts consensus on application of comprehensive geriatric assessment[J]. Zhonghua Lao Nian Yi Xue Za Zhi, 2017, 36: 471-477. DOI: 10.3760/cma.j.issn.0254-9026.2017.05.001
    [3]
    李杰, 程秀丽, 关向荣, 等.住院患者老年综合征发生率及评估分析[J].中华老年医学杂志, 2017, 36: 266-268. DOI: 10.3760/cma.j.issn.0254-9026.2017.03.010

    Li J, Cheng XL, Guan XR, et al. Incidence and evaluation of geriatric syndromes in hospitalized patients[J]. Zhonghua Lao Nian Yi Xue Za Zhi, 2017, 36: 266-268. DOI: 10.3760/cma.j.issn.0254-9026.2017.03.010
    [4]
    Arik G, Varan HD, Yavuz BB, et al.Validation of Katz index of independence in activities of daily living in Turkish older adults[J]. Arch Gerontol Geriatr, 2015, 61:344-350. DOI: 10.1016/j.archger.2015.08.019
    [5]
    Bier N, Belchior Pda C, Paquette G, et al. The Instru-mental Activity of Daily Living Profile in Aging: A Feasibility Study[J]. J Alzheimers Dis, 2016, 52:1361-1371. DOI: 10.3233/JAD-150957
    [6]
    Charlson ME, Pompei P, Ales KL, et al. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation[J]. J Chronic Dis, 1987, 40:373-383. DOI: 10.1016/0021-9681(87)90171-8
    [7]
    陈阳希, 史兆荣, 朱小蔚, 等.共病状态评估工具的临床应用及研究进展[J].中华老年多器官疾病杂志, 2017, 16:147-151. DOI: 10.11915/j.issn.1671-5403.2017.02.034

    Chen YX, Shi ZR, Zhu XW, et al. Clinical application and progress of testing and assessments for comorbidity[J]. Zhonghua Lao Nian Duo Qi Guan Ji Bing Za Zhi, 2017, 16:147-151. DOI: 10.11915/j.issn.1671-5403.2017.02.034
    [8]
    Koren-Hakim T, Weiss A, Hershkovitz A, et al. Comparing the adequacy of the MNA-SF, NRS-2002 and MUST nutritional tools in assessing malnutrition in hip fracture operated elderly patients[J]. Clin Nutr, 2016, 35:1053-1058. DOI: 10.1016/j.clnu.2015.07.014
    [9]
    Rockwood K, Song X, MacKnight C, et al. A global clinical measure of fitness and frailty in elderly people[J]. CMAJ, 2005, 173:489-495. DOI: 10.1503/cmaj.050051
    [10]
    Chen TY, Janke MC. Predictors of falls among community-dwelling older adults with cancer: results from the health and retirement study[J]. Support Care Cancer, 2014, 22: 479-485. DOI: 10.1007/s00520-013-2000-7
    [11]
    Singh M, Rihal CS, Lennon RJ, et al. Influence of Frailty and Health Status on Outcomes in Patients with Coronary Disease Undergoing Percutaneous Revascularization[J]. Circ Cardiovasc Qual Outcomes, 2011, 4: 496-502. DOI: 10.1161/CIRCOUTCOMES.111.961375
    [12]
    Bariani GM, de Celis Ferrari AC, Precivale M, et al. Sample Size Calculation in Oncology Trials: Quality of Reporting and Implications for Clinical Cancer Research[J]. Am J Clin Oncol, 2014, 38:570-574.
    [13]
    中华医学会心血管病学分会, 中华心血管病杂志编辑委员会.急性ST段抬高型心肌梗死诊断和治疗指南[J].中华心血管病杂志, 2015, 43: 380-393. DOI: 10.3760/cma.j.issn.0253-3758.2015.05.003

    Cardiovascular Society of Chinese Medical Association. Guidelines for diagnosis and treatment of acute ST segment elevation myocardial infarction[J]. Zhonghua Xin Xue Guan Bing Za Zhi, 2015, 43: 380-393. DOI: 10.3760/cma.j.issn.0253-3758.2015.05.003
    [14]
    中华医学会神经病学分会, 中华医学会神经病学分会脑血管病学组.中国急性缺血性脑卒中诊治指南2014[J].中华神经科杂志, 2015, 48: 246-257. DOI: 10.3760/cma.j.issn.1006-7876.2015.04.002

    Neurology Society of Chinese Medical Association. Guidelines for diagnosis and treatment of Acute Ischemic Stroke in China 2014[J]. Zhonghua Shen Jing Ke Za Zhi, 2015, 48: 246-257. DOI: 10.3760/cma.j.issn.1006-7876.2015.04.002
    [15]
    中华医学会心血管病学分会, 中华心血管病杂志编辑委员会.急性心力衰竭诊断和治疗指南[J].中华心血管病杂志, 2010, 38: 195-208.

    Cardiovascular Society of Chinese Medical Association. Guidelines for diagnosis and treatment of acute heart failure[J]. Zhonghua Xin Xue Guan Bing Za Zhi, 2010, 38: 195-208.
    [16]
    Tse G, Gong M, TNunez J, et al. Frailty and Mortality Outcomes After Percutaneous Coronary Intervention: A Systematic Review and Meta-Analysis[J]. J Am Med Dir Assoc, 2017, 18:1097.e1-1097.e10. DOI: 10.1016/j.jamda.2017.09.002
    [17]
    Veronese N, Cereda E, Stubbs B, et al. Risk of cardiovascular disease morbidity and mortality in frail and pre-frail older adults: Results from a meta-analysis and exploratory meta-regression analysis[J]. Ageing Res Rev, 2017, 35:63-73. DOI: 10.1016/j.arr.2017.01.003
    [18]
    Ekerstad N, Swahn E, Janzon M, et al. Frailty is independently associated with short-term outcomes for elderly patients with non-ST-segment elevation myocardial infarction[J]. Circulation, 2011, 124:2397-2404. DOI: 10.1161/CIRCULATIONAHA.111.025452
    [19]
    Ekerstad N, Swahn E, Janzon M, et al. Frailty is independently associated with 1-year mortality for elderly patients with non-ST-segment elevation myocardial infarction[J]. Eur J Prev Cardiol, 2014, 21:1216-1224. DOI: 10.1177/2047487313490257
    [20]
    康琳, 朱鸣雷, 刘晓红, 等.衰弱与老年人冠状动脉粥样硬化性心脏病的相关性研究[J].中华老年医学杂志, 2015, 34: 951-955.

    Kang L, Zhu ML, Liu XH, et al. Correlation between frailty and coronary heart disease in the elderly[J]. Zhonghua Lao Nian Yi Xue Za Zhi, 2015, 34: 951-955.
    [21]
    Kang L, Zhang SY, Zhu WL, et al. Is frailty associated with short-term outcomes for elderly patients with acute coronary syndrome?[J]. J Geriatr Cardiol, 2015, 12:662-667.
    [22]
    苏琳凡, 张宁, 王倩, 等.皮疹, 心力衰竭, 肾功能不全, 嗜酸性粒细胞增多:一例高龄衰弱老年患者[J].协和医学杂志, 2020, 11:479-485.

    Su LF, Zhang N, Wang Q, et al. Rash, Heart Failure, Renal Insufficiency, and Hypereosinophilia in an Elderly Frail Male[J]. Xie He Yi Xue Za Zhi, 2020, 11:479-485.
    [23]
    Kang L, Gao Y, Liu XH, et al. Effects of whey protein nutritional supplement on muscle function among community-dwelling frail older people: A multicenter study in China[J]. Arch Gerontol Geriatr, 2019, 83: 7-12. DOI: 10.1016/j.archger.2019.03.012
    • Related Articles

  • Related Articles

    [1]MA Xing, LIU Chang. Prognosis and Treatment Strategies of FIGO 2018 Stage ⅢC Cervical Cancer[J]. Medical Journal of Peking Union Medical College Hospital, 2024, 15(6): 1253-1260. DOI: 10.12290/xhyxzz.2024-0097
    [2]WANG Yajuan, WANG Yuan, REN Xinyu. Correlation of CD117 and DOG1 Expression with the Clinicopathological Features and Prognosis in Triple-negative Breast Cancer[J]. Medical Journal of Peking Union Medical College Hospital, 2024, 15(3): 616-623. DOI: 10.12290/xhyxzz.2023-0454
    [3]ZHOU Gaosheng, WANG Xiaoting, LIU Jingjing, ZHANG Hongmin, ZHANG Qing, LIU Dawei. Relationship between Oxygen Extraction Ratio and Prognosis in Septic Shock Patients During Early Resuscitation[J]. Medical Journal of Peking Union Medical College Hospital, 2023, 14(6): 1217-1223. DOI: 10.12290/xhyxzz.2023-0008
    [4]LIU Huan, HUANG Xiaoling, DAI Mengying, GUO Jiejie, GAO feng. Clinical Characteristics and Inflammatory Markers of Omicron BA.5.2 Variant Infection in Hospitalized Patients and Their Predictive Role in Disease Prognosis[J]. Medical Journal of Peking Union Medical College Hospital, 2023, 14(5): 1038-1045. DOI: 10.12290/xhyxzz.2023-0055
    [5]Jian-hua DENG, Han-zhong LI. Clinical Diagnosis and Prognosis of Metastatic Pheochromocytoma and Paraganglioma[J]. Medical Journal of Peking Union Medical College Hospital, 2019, 10(6): 654-659. DOI: 10.3969/j.issn.1674-9081.2019.06.018
    [6]Jia-qi ZHANG, Lei LIU, Gui-ge WANG, Wen-liang BAI, Shan-qing LI. Clinical Pathological Features and Prognosis of Non-small Cell Lung Cancer with Skip N2 Lymph Node Metastasis[J]. Medical Journal of Peking Union Medical College Hospital, 2019, 10(3): 272-277. DOI: 10.3969/j.issn.1674-9081.2019.03.015
    [7]Ran ZHOU, Tong-juan ZOU, Wan-hong YIN, Yao QIN, Yi LI, Jing YANG, Yan KANG. nfluence of Mitral Regurgitation on the Prognosis of Patients with Septic Shock[J]. Medical Journal of Peking Union Medical College Hospital, 2018, 9(5): 426-430. DOI: 10.3969/j.issn.1674-9081.2018.05.010
    [8]Cheng HUANG, Ye-ye CHEN, Shan-qing LI, Xiao-yun ZHOU, Hong-sheng LIU, Li LI, Ying-zhi QIN, Jia HE, Dong-jie MA. Ectopic Adrenocorticotropic Hormone Syndrome Caused by Thoracic Neuroendocrine Tumors: Surgical Treatment and Prognosis Factors[J]. Medical Journal of Peking Union Medical College Hospital, 2017, 8(2-3): 147-153. DOI: 10.3969/j.issn.1674-9081.2017.03.012
    [9]Qing-yuan DENG, Yi-cong YE, Ying ZHONG, Miao-miao SHENG, Feng-ming HUANG, Cheng-yu JIANG, Shu-yang ZHANG. Angiotensin Ⅱ in Predicting the In-hospital Prognosis of Patients Undergoing Elective Percutaneous Coronary Intervention[J]. Medical Journal of Peking Union Medical College Hospital, 2016, 7(1): 13-17. DOI: 10.3969/j.issn.1674-9081.2016.01.003
    [10]Yu YANG, Quan-zong MAO, Han-zhong LI, Zhi-gang JI, Wei-gang YAN, Shi RONG, Guang-hua LIU, Wei-feng XU, He XIAO, Hui-jun WANG. Clinical Features and Prognosis of Paraneoplastic Syndromes in Renal Malignancies[J]. Medical Journal of Peking Union Medical College Hospital, 2012, 3(2): 195-199. DOI: 10.3969/j.issn.1674-9081.2012.02.014

  • Cited by

    Periodical cited type(13)

    1. 李亚姿，许晓萌，刘晓颖，沙金玉，王莉莉，刘婉露. 老年心血管疾病合并衰弱的研究进展. 中国医药科学. 2024(11): 42-45+69 .
    2. 姚子俊，刘倩慧，何玉立，徐云凡，吴军. 衰弱评估对老年冠状动脉综合征预后影响的研究进展. 中华老年心脑血管病杂志. 2024(12): 1508-1511 .
    3. 邹晓，范利. 老年心血管疾病与衰弱相关性及研究进展. 中国临床保健杂志. 2023(01): 7-12 .
    4. 周雪莲，于洪威，李晓波，苗晓. 衰弱与老年冠心病患者预后关系的Meta分析. 中华现代护理杂志. 2023(08): 1055-1061 .
    5. 秦巍，薛文平，祝丽丽，单伟超，刘佳梅，于海燕，吕新琳，冯超群，刘静怡，卜海伟. 急性冠脉综合征的不同评分工具对介入治疗后患者预后评估的价值. 中国临床保健杂志. 2023(03): 407-411 .
    6. 李娟，汪美林，林瑞桢，章雯，朱美. 老年综合评估护理干预对冠心病衰弱患者的效果观察. 护理实践与研究. 2023(24): 3713-3717 .
    7. 章妙玉，高燕飞，盛晓丹，王秋燕，钟玲玲. 护理干预下主动锻炼对高龄衰弱患者的影响. 中国现代医生. 2022(09): 180-183+192 .
    8. 王娟娟，许小明，刘宁，宁彬，段永丽. 实验室衰弱指数FI-Lab对预测患者不良健康结局的应用. 中国循证心血管医学杂志. 2022(03): 382-384 .
    9. 张颖，徐晓东，方中，刘大双，施武安，严婷婷. 老年冠心病患者的衰弱评估与6min步行试验的相关性研究. 安徽医学. 2022(05): 526-529 .
    10. 孙啸云，申玉英，纪木火，徐建国，沈锦春. 老年骨科手术患者术前衰弱与术后1年内死亡的相关性. 临床麻醉学杂志. 2022(04): 395-399 .
    11. 邹海妹，陈培英，黄丽君. 老年冠心病介入治疗患者衰弱发生情况调查及其影响因素分析. 心血管病防治知识. 2022(11): 82-85 .
    12. 卢勇. 探析药物联合心肺运动康复对居家老年冠心病伴衰弱患者心肺功能、睡眠及生命质量的影响. 中西医结合心血管病电子杂志. 2022(21): 25-28 .
    13. 欧阳银，谭烨，邓鑫. 冠状动脉粥样硬化性心脏病临床研究中回归分析的应用概况. 中国医药科学. 2021(18): 44-47 .

    Other cited types(11)

Catalog

    Get Citation
    PDF
    XML

    Article Metrics

    Article views (1508) PDF downloads (55) Cited by(24)
    Related
    Links: National Health Commission of the People's Republic of China Chinese Academy of Medical Sciences(CAMS) AMLC Check CNKI Database CNKI Term Online Chinese General Practice
    Address：Room 302,Third Floor,Building 7, No. 1 Shuaifuyuan, Wangfujing, Dongcheng District, Beijing 100730, China
    Tel：010-69154261/4262
    E - mail：medj@pumch.cn mjpumch@126.com
    Copyright of website：Editorial Office of Medical Journal of Peking Union Medical College Hospital

    Supported by: Beijing Renhe Information Technology Co., Ltd.  Baidu Analytics

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return
    x Close Forever Close