Evaluation of risk stratification program based on trajectories of functional capacity in patients with acute coronary syndrome: The REACP study
BackgroundAs a validated assessment tool for functional disability (activities of daily living), the Barthel index (BI) assessed initially at admission has the potential to stratify patients with high-risk acute coronary syndrome (ACS). Dynamic trajectory evaluation of functional capacity in hospita...
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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.2022.1020488/full |
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| author | Dongze Li Xiaoli Chen Fanghui Li Yu Jia Zhilin Li Yi Liu Lei Ye Yongli Gao Wei Zhang Hong Li Rui Zeng Zhi Wan Zhi Zeng Yu Cao |
| author_facet | Dongze Li Xiaoli Chen Fanghui Li Yu Jia Zhilin Li Yi Liu Lei Ye Yongli Gao Wei Zhang Hong Li Rui Zeng Zhi Wan Zhi Zeng Yu Cao |
| author_sort | Dongze Li |
| collection | DOAJ |
| description | BackgroundAs a validated assessment tool for functional disability (activities of daily living), the Barthel index (BI) assessed initially at admission has the potential to stratify patients with high-risk acute coronary syndrome (ACS). Dynamic trajectory evaluation of functional capacity in hospitals may provide more prognostic information. We aimed to establish a novel dynamic BI-based risk stratification program (DBRP) during hospitalization to predict outcomes among ACS patients.MethodsA total of 2,837 ACS patients were included from the Retrospective Multicenter Study for Early Evaluation of Acute Chest Pain. The DBRP rating (low, medium, and high-risk categories) was calculated from dynamic BI at admission and discharge. The primary outcome was all-cause mortality, and the secondary outcome was cardiac mortality.ResultsOf all the included patients, 312 (11%) died during a median follow-up period of 18.0 months. Kaplan–Meier analysis revealed that the cumulative mortality was significantly higher in patients in the higher risk category according to the DBRP. Multivariable Cox regression analysis indicated that, compared to the low-risk category, the higher risk category in the DBRP was an independent strong predictor of all-cause mortality after adjusting for confounding factors (medium-risk category: hazard ratio [HR]: 1.756, 95% confidence interval [95% CI]: 1.214–2.540; P = 0.003; high-risk category: HR: 5.052, 95% CI: 3.744–6.817; P < 0.001), and the same result was found for cardiac mortality.ConclusionThe DBRP was a useful risk stratification tool for the early dynamic assessment of patients with ACS.Clinical trial registration[http://www.chictr.org.cn], identifier [ChiCTR1900024657]. |
| first_indexed | 2024-04-13T04:17:06Z |
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| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-04-13T04:17:06Z |
| publishDate | 2022-12-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-ee1ede8c3b8c4816acdb441dde3c83632022-12-22T03:02:57ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2022-12-01910.3389/fcvm.2022.10204881020488Evaluation of risk stratification program based on trajectories of functional capacity in patients with acute coronary syndrome: The REACP studyDongze Li0Xiaoli Chen1Fanghui Li2Yu Jia3Zhilin Li4Yi Liu5Lei Ye6Yongli Gao7Wei Zhang8Hong Li9Rui Zeng10Zhi Wan11Zhi Zeng12Yu Cao13Department of Emergency Medicine and West China School of Nursing, Laboratory of Emergency Medicine, Disaster Medical Center, West China Hospital, West China School of Medicine, Sichuan University, Chengdu, ChinaDepartment of Emergency Medicine and West China School of Nursing, Laboratory of Emergency Medicine, Disaster Medical Center, West China Hospital, West China School of Medicine, Sichuan University, Chengdu, ChinaDepartment of Cardiology, West China Hospital, West China School of Medicine, Sichuan University, Chengdu, ChinaDepartment of Emergency Medicine and West China School of Nursing, Laboratory of Emergency Medicine, Disaster Medical Center, West China Hospital, West China School of Medicine, Sichuan University, Chengdu, ChinaDepartment of Emergency Medicine and West China School of Nursing, Laboratory of Emergency Medicine, Disaster Medical Center, West China Hospital, West China School of Medicine, Sichuan University, Chengdu, ChinaDepartment of Emergency Medicine and West China School of Nursing, Laboratory of Emergency Medicine, Disaster Medical Center, West China Hospital, West China School of Medicine, Sichuan University, Chengdu, ChinaDepartment of Emergency Medicine and West China School of Nursing, Laboratory of Emergency Medicine, Disaster Medical Center, West China Hospital, West China School of Medicine, Sichuan University, Chengdu, ChinaDepartment of Emergency Medicine and West China School of Nursing, Laboratory of Emergency Medicine, Disaster Medical Center, West China Hospital, West China School of Medicine, Sichuan University, Chengdu, ChinaDepartment of Emergency Medicine and West China School of Nursing, Laboratory of Emergency Medicine, Disaster Medical Center, West China Hospital, West China School of Medicine, Sichuan University, Chengdu, ChinaDepartment of Emergency Medicine and West China School of Nursing, Laboratory of Emergency Medicine, Disaster Medical Center, West China Hospital, West China School of Medicine, Sichuan University, Chengdu, ChinaDepartment of Cardiology, West China Hospital, West China School of Medicine, Sichuan University, Chengdu, ChinaDepartment of Emergency Medicine and West China School of Nursing, Laboratory of Emergency Medicine, Disaster Medical Center, West China Hospital, West China School of Medicine, Sichuan University, Chengdu, ChinaDepartment of Emergency Medicine and West China School of Nursing, Laboratory of Emergency Medicine, Disaster Medical Center, West China Hospital, West China School of Medicine, Sichuan University, Chengdu, ChinaDepartment of Emergency Medicine and West China School of Nursing, Laboratory of Emergency Medicine, Disaster Medical Center, West China Hospital, West China School of Medicine, Sichuan University, Chengdu, ChinaBackgroundAs a validated assessment tool for functional disability (activities of daily living), the Barthel index (BI) assessed initially at admission has the potential to stratify patients with high-risk acute coronary syndrome (ACS). Dynamic trajectory evaluation of functional capacity in hospitals may provide more prognostic information. We aimed to establish a novel dynamic BI-based risk stratification program (DBRP) during hospitalization to predict outcomes among ACS patients.MethodsA total of 2,837 ACS patients were included from the Retrospective Multicenter Study for Early Evaluation of Acute Chest Pain. The DBRP rating (low, medium, and high-risk categories) was calculated from dynamic BI at admission and discharge. The primary outcome was all-cause mortality, and the secondary outcome was cardiac mortality.ResultsOf all the included patients, 312 (11%) died during a median follow-up period of 18.0 months. Kaplan–Meier analysis revealed that the cumulative mortality was significantly higher in patients in the higher risk category according to the DBRP. Multivariable Cox regression analysis indicated that, compared to the low-risk category, the higher risk category in the DBRP was an independent strong predictor of all-cause mortality after adjusting for confounding factors (medium-risk category: hazard ratio [HR]: 1.756, 95% confidence interval [95% CI]: 1.214–2.540; P = 0.003; high-risk category: HR: 5.052, 95% CI: 3.744–6.817; P < 0.001), and the same result was found for cardiac mortality.ConclusionThe DBRP was a useful risk stratification tool for the early dynamic assessment of patients with ACS.Clinical trial registration[http://www.chictr.org.cn], identifier [ChiCTR1900024657].https://www.frontiersin.org/articles/10.3389/fcvm.2022.1020488/fullacute coronary syndrometrajectoryfunctional capacityrisk stratificationactivities of daily living |
| spellingShingle | Dongze Li Xiaoli Chen Fanghui Li Yu Jia Zhilin Li Yi Liu Lei Ye Yongli Gao Wei Zhang Hong Li Rui Zeng Zhi Wan Zhi Zeng Yu Cao Evaluation of risk stratification program based on trajectories of functional capacity in patients with acute coronary syndrome: The REACP study Frontiers in Cardiovascular Medicine acute coronary syndrome trajectory functional capacity risk stratification activities of daily living |
| title | Evaluation of risk stratification program based on trajectories of functional capacity in patients with acute coronary syndrome: The REACP study |
| title_full | Evaluation of risk stratification program based on trajectories of functional capacity in patients with acute coronary syndrome: The REACP study |
| title_fullStr | Evaluation of risk stratification program based on trajectories of functional capacity in patients with acute coronary syndrome: The REACP study |
| title_full_unstemmed | Evaluation of risk stratification program based on trajectories of functional capacity in patients with acute coronary syndrome: The REACP study |
| title_short | Evaluation of risk stratification program based on trajectories of functional capacity in patients with acute coronary syndrome: The REACP study |
| title_sort | evaluation of risk stratification program based on trajectories of functional capacity in patients with acute coronary syndrome the reacp study |
| topic | acute coronary syndrome trajectory functional capacity risk stratification activities of daily living |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2022.1020488/full |
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