Frailty rose in heart attack patients and was linked to death
Moderate or severe frailty rose from 22.8% in 2005 to 42.1% in 2019 among adults hospitalized with heart attacks in England and Wales.
Limit: Frail patients received less evidence-based care, confounding the link to death
Edited by Boris Djordjevic · AgingResearch.News
An observational cohort study analyzed linked national records for 931,133 consecutive adults hospitalized with heart attacks in England and Wales between 2005 and 2019. Researchers assessed frailty, reduced resilience to illness and other stresses, at admission using an index based on hospital records. Median age ranged from 61 years in fit patients to 80 in those with severe frailty. Women made up 24.7% and 45.3% of these groups, respectively.
Increasing frailty was associated with less use of recommended care, including tests to view heart arteries, medicines to reduce blood clotting and referral to cardiac rehabilitation. Compared with fit patients, those with severe frailty had an adjusted hazard ratio of 3.01 for death from any cause within one year. This measured higher relative risk during follow-up, not an absolute death rate.
Why it matters
Frailty concerns vulnerability to illness, an important issue in aging. The study bears on how to assess care needs and prognosis after a heart attack.
Caveats
The observational design cannot show that frailty caused poorer care or worse outcomes. The findings concern adults hospitalized with heart attacks in England and Wales and were reported in a conference abstract.
