Association between frailty and short- and long-term mortality in patients with critical acute myocardial infarction: Results from MIMIC-IV
BackgroundFrailty has been recognized as an important prognostic indicator in patients with acute myocardial infarction (AMI). However, no study has focused on critical AMI patients. We aimed to determine the impact of frailty on short- and long-term mortality risk in critical AMI patients.MethodsDa...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-12-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2022.1056037/full |
| _version_ | 1828270767610003456 |
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| author | Weimin Bai Benchuan Hao Benchuan Hao Wenwen Meng Ji Qin Ji Qin Weihao Xu Lijie Qin |
| author_facet | Weimin Bai Benchuan Hao Benchuan Hao Wenwen Meng Ji Qin Ji Qin Weihao Xu Lijie Qin |
| author_sort | Weimin Bai |
| collection | DOAJ |
| description | BackgroundFrailty has been recognized as an important prognostic indicator in patients with acute myocardial infarction (AMI). However, no study has focused on critical AMI patients. We aimed to determine the impact of frailty on short- and long-term mortality risk in critical AMI patients.MethodsData from the Medical Information Mart for Intensive Care (MIMIC)-IV database was used. Frailty was assessed using the Hospital Frailty Risk Score (HFRS). Outcomes were in-hospital mortality and 1-year mortality. Logistic regression and Cox proportional-hazards models were used to investigate the association between frailty and outcomes.ResultsAmong 5,003 critical AMI patients, 2,176 were non-frail (43.5%), 2,355 were pre-frail (47.1%), and 472 were frail (9.4%). The in-hospital mortality rate was 13.8%, and the 1-year mortality rate was 29.5%. In our multivariable model, frailty was significantly associated with in-hospital mortality [odds ratio (OR) = 1.30, 95% confidence interval (CI): 1.20–1.41] and 1-year mortality [hazard ratio (HR) = 1.29, 95% CI: 1.24–1.35] as a continuous variable (per five-score increase). When assessed as categorical variables, pre-frailty and frailty were both associated with in-hospital mortality (OR = 2.80, 95% CI: 2.19–3.59 and OR = 2.69, 95% CI: 1.93–3.73, respectively) and 1-year mortality (HR = 2.32, 95% CI: 2.00–2.69 and HR = 2.81, 95% CI: 2.33–3.39, respectively) after adjustment for confounders. Subgroup analysis showed that frailty was only associated with in-hospital mortality in critically ill patients with non-ST-segment elevation myocardial infarction (STEMI) but not STEMI (p for interaction = 0.012). In addition, frailty was associated with 1-year mortality in both STEMI and non-STEMI patients (p for interaction = 0.447). The addition of frailty produced the incremental value over the initial model generated by baseline characteristics for both in-hospital and 1-year mortality.ConclusionFrailty, as assessed by the HFRS, was associated with both in-hospital and 1-year mortality in critical AMI patients. Frailty improves the prediction of short- and long-term mortality in critical AMI patients and may have potential clinical applications. |
| first_indexed | 2024-04-13T05:46:25Z |
| format | Article |
| id | doaj.art-18906f57ec17421da0463757f57f3a84 |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-04-13T05:46:25Z |
| publishDate | 2022-12-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-18906f57ec17421da0463757f57f3a842022-12-22T02:59:56ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2022-12-01910.3389/fcvm.2022.10560371056037Association between frailty and short- and long-term mortality in patients with critical acute myocardial infarction: Results from MIMIC-IVWeimin Bai0Benchuan Hao1Benchuan Hao2Wenwen Meng3Ji Qin4Ji Qin5Weihao Xu6Lijie Qin7Department of Emergency, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, People’s Hospital of Henan University, Zhengzhou, ChinaMedical School of Chinese People’s Liberation Army (PLA), Beijing, ChinaDepartment of Cardiology, The Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, ChinaThe Northern District of PLA General Hospital, Beijing, ChinaMedical School of Chinese People’s Liberation Army (PLA), Beijing, ChinaDepartment of Cardiology, The Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, ChinaHaikou Cadre’s Sanitarium of Hainan Military Region, Haikou, ChinaDepartment of Emergency, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, People’s Hospital of Henan University, Zhengzhou, ChinaBackgroundFrailty has been recognized as an important prognostic indicator in patients with acute myocardial infarction (AMI). However, no study has focused on critical AMI patients. We aimed to determine the impact of frailty on short- and long-term mortality risk in critical AMI patients.MethodsData from the Medical Information Mart for Intensive Care (MIMIC)-IV database was used. Frailty was assessed using the Hospital Frailty Risk Score (HFRS). Outcomes were in-hospital mortality and 1-year mortality. Logistic regression and Cox proportional-hazards models were used to investigate the association between frailty and outcomes.ResultsAmong 5,003 critical AMI patients, 2,176 were non-frail (43.5%), 2,355 were pre-frail (47.1%), and 472 were frail (9.4%). The in-hospital mortality rate was 13.8%, and the 1-year mortality rate was 29.5%. In our multivariable model, frailty was significantly associated with in-hospital mortality [odds ratio (OR) = 1.30, 95% confidence interval (CI): 1.20–1.41] and 1-year mortality [hazard ratio (HR) = 1.29, 95% CI: 1.24–1.35] as a continuous variable (per five-score increase). When assessed as categorical variables, pre-frailty and frailty were both associated with in-hospital mortality (OR = 2.80, 95% CI: 2.19–3.59 and OR = 2.69, 95% CI: 1.93–3.73, respectively) and 1-year mortality (HR = 2.32, 95% CI: 2.00–2.69 and HR = 2.81, 95% CI: 2.33–3.39, respectively) after adjustment for confounders. Subgroup analysis showed that frailty was only associated with in-hospital mortality in critically ill patients with non-ST-segment elevation myocardial infarction (STEMI) but not STEMI (p for interaction = 0.012). In addition, frailty was associated with 1-year mortality in both STEMI and non-STEMI patients (p for interaction = 0.447). The addition of frailty produced the incremental value over the initial model generated by baseline characteristics for both in-hospital and 1-year mortality.ConclusionFrailty, as assessed by the HFRS, was associated with both in-hospital and 1-year mortality in critical AMI patients. Frailty improves the prediction of short- and long-term mortality in critical AMI patients and may have potential clinical applications.https://www.frontiersin.org/articles/10.3389/fcvm.2022.1056037/fullfrailtyHospital Frailty Risk Scoreacute myocardial infarctioncritically ill patientsmortality |
| spellingShingle | Weimin Bai Benchuan Hao Benchuan Hao Wenwen Meng Ji Qin Ji Qin Weihao Xu Lijie Qin Association between frailty and short- and long-term mortality in patients with critical acute myocardial infarction: Results from MIMIC-IV Frontiers in Cardiovascular Medicine frailty Hospital Frailty Risk Score acute myocardial infarction critically ill patients mortality |
| title | Association between frailty and short- and long-term mortality in patients with critical acute myocardial infarction: Results from MIMIC-IV |
| title_full | Association between frailty and short- and long-term mortality in patients with critical acute myocardial infarction: Results from MIMIC-IV |
| title_fullStr | Association between frailty and short- and long-term mortality in patients with critical acute myocardial infarction: Results from MIMIC-IV |
| title_full_unstemmed | Association between frailty and short- and long-term mortality in patients with critical acute myocardial infarction: Results from MIMIC-IV |
| title_short | Association between frailty and short- and long-term mortality in patients with critical acute myocardial infarction: Results from MIMIC-IV |
| title_sort | association between frailty and short and long term mortality in patients with critical acute myocardial infarction results from mimic iv |
| topic | frailty Hospital Frailty Risk Score acute myocardial infarction critically ill patients mortality |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2022.1056037/full |
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