ADMISSION FRAILTY SCORE AS A GOOD CLINICAL SUBSTITUTE OF SOFA SCORE TO PROGNOSTICATE POST-PERCUTANEOUS CORONARY INTERVENTION PATIENTS ON ADVANCED LIFE-SUPPORT

Authors

  • Mirza Yousuf Baig National Institute of Cardiovascular Diseases, Karachi-Pakistan
  • Muhammad Imran Ansari National Institute of Cardiovascular Diseases, Karachi-Pakistan
  • Mujtaba Hassan National Institute of Cardiovascular Diseases, Karachi-Pakistan
  • Muhammad Shoaib Arif National Institute of Cardiovascular Diseases, Karachi-Pakistan
  • Aziz ur Rehman Memon National Institute of Cardiovascular Diseases, Karachi-Pakistan
  • Madiha Umair National Institute of Cardiovascular Diseases, Karachi-Pakistan
  • Jawed Abubaker National Institute of Cardiovascular Diseases, Karachi-Pakistan

Keywords:

myocardial infarction, advanced life-support, SOFA score, frailty score

Abstract

Background: This study aimed to assess and compare the prognostic value of frailty score (FS), Sequential Organ Failure Assessment (SOFA) score, and additive of FS and SOFA score, at the time of admission to the coronary care unit (CCU), for the prediction of short-term poor prognosis in post-myocardial infarction (MI) patients, requiring advanced life-support. Methods: A cohort of post-MI patients admitted to CCU. The FS and SOFA score were obtained at the time of CCU admission. The prognostic value of FS, SOFA score, and FS+SOFA score was assessed to predict in-hospital and short-term follow-up mortality. Results: The study sample consisted of 312 patients: females were 27.2% (85), and the mean age was 60.32±11.51 years. A concordance rate of 51.8% was observed between admission FS (≥3) and SOFA score (≥9). A total of 67.3% (210) patients were categorized as moderate to severely frail (≥3), while the SOFA score identified 26.0% (81) high-risk (≥9) patients. The receiver operating characteristics (ROC) analysis showed an area under the curve (AUC) of 0.707 [0.638–0.776], 0.764 [0.704–0.825], and 0.783 [0.724–0.842] for in-hospital mortality and 0.684 [0.621–0.746], 0.718 [0.659–0.778], and 0.744 [0.687–0.801] for 180-day cumulative mortality against FS, SOFA, and FS+SOFA score, respectively. A hazard ratio of 2.75 [1.61–4.71] and 2.51 [1.68–3.75] were observed for mortality during 180-day follow-up among patients with FS ≥3 and SOFA score ≥9, respectively. Conclusion: CCU admission Frailty Score is a good clinical substitute for SOFA score for an early prognostication of post-MI patients on advanced life-support.

Author Biographies

Mirza Yousuf Baig, National Institute of Cardiovascular Diseases, Karachi-Pakistan

 

Muhammad Imran Ansari, National Institute of Cardiovascular Diseases, Karachi-Pakistan

 

Mujtaba Hassan, National Institute of Cardiovascular Diseases, Karachi-Pakistan

 

Muhammad Shoaib Arif, National Institute of Cardiovascular Diseases, Karachi-Pakistan

 

Aziz ur Rehman Memon, National Institute of Cardiovascular Diseases, Karachi-Pakistan

 

Madiha Umair, National Institute of Cardiovascular Diseases, Karachi-Pakistan

 

Jawed Abubaker, National Institute of Cardiovascular Diseases, Karachi-Pakistan

 

References

Benjamin EJ, Virani SS, Callaway CW, Chamberlain AM, Chang AR, Cheng S, et al. Heart disease and stroke statistics—2018 update: a report from the American Heart Association. Circulation 2018;137(12):e67–492.

Ariza Sole A, Salazar-Mendiguchia J, Lorente-Tordera V, Sanchez-Salado JC, Gonzalez-Costello J, Moliner-Borja P, et al. Invasive mechanical ventilation in acute coronary syndromes in the era of percutaneous coronary intervention. Eur Heart J Acute Cardiovasc Care 2013;2:109–17.

Lopez Messa JB, Andrés De Llano JM, Berrocal De La Fuente CA, Pascual Palacin R, Analisis Retraso Infarto Agudo M. Characteristics of acute myocardial infarction patients treated with mechanical ventilation. Data from the ARIAM registry. Rev Esp Cardiol 2001;54:851–9.

Kouraki K, Schneider S, Uebis R, Tebbe U, Klein HH, Janssens U, et al. Characteristics and clinical outcome of 458 patients with acute myocardial infarction requiring mechanical ventilation. Results of the BEAT registry of the ALKK-study group. Clin Res Cardiol 2011;100:235.

Zahger D, Maimon N, Novack V, Wolak A, Friger M, Gilutz H, et al. Clinical characteristics and prognostic factors in patients with complicated acute coronary syndromes requiring prolonged mechanical ventilation. Am J Cardiol 2005;96:1644.

Lesage A, Ramakers M, Daubin C, Verrier V, Beynier D, Charbonneau P, et al. Complicated acute myocardial infarction requiring mechanical ventilation in the intensive care unit: prognostic factors of clinical outcome in a series of 157 patients. Crit Care Med 2004;32(1):100–5.

Aoyama D, Morishita T, Uzui H, Miyazaki S, Ishida K, Kaseno K, et al. Sequential organ failure assessment score on admission predicts long‐term mortality in acute heart failure patients. ESC Heart Fail 2020;7(1):245–53.

Bennett CE, Wright RS, Jentzer J, Gajic O, Murphree DH, Murphy JG, et al. Severity of illness assessment with application of the APACHE IV predicted mortality and outcome trends analysis in an academic cardiac intensive care unit. J Crit Care 2019;50:242–6.

Nishihira K, Watanabe N, Kuriyama N, Shibata Y. Clinical outcomes of nonagenarians with acute myocardial infarction who undergo percutaneous coronary intervention. Eur Heart J Acute Cardiovasc Care 2020;9(5):488–95.

Dodson JA, Hochman JS, Roe MT, Chen AY, Chaudhry SI, Katz S, et al. The association of frailty with in-hospital bleeding among older adults with acute myocardial infarction: Insights from the ACTION Registry. JACC Cardiovasc Interv 2018;11:2287–96.

Lambden S, Laterre PF, Levy MM, Francois B. The SOFA score—development, utility and challenges of accurate assessment in clinical trials. Crit Care 2019;23(1):1–9.

Singh M, Stewart R, White H. Importance of frailty in patients with cardiovascular disease. Eur Heart J 2014;35(26):1726–31.

Falvey JR, Ferrante LE. Frailty assessment in the ICU: translation to 'real-world' clinical practice. Anaesthesia 2019;74(6):700–3.

Pugh RJ, Battle CE, Thorpe C, Lynch C, Williams JP, Campbell A, et al. Reliability of frailty assessment in the critically ill: a multicentre prospective observational study. Anaesthesia 2019;74(6):758–64.

Pugh RJ, Ellison A, Pye K, Subbe CP, Thorpe CM, Lone NI, et al. Feasibility and reliability of frailty assessment in the critically ill: a systematic review. Crit Care 2018;22(1):49.

Bertschi D, Waskowski J, Schilling M, Donatsch C, Schefold JC, Pfortmueller CA. Methods of Assessing Frailty in the Critically Ill: A Systematic Review of the Current Literature. Gerontology 2022;68(12):1321–49.

Dodson JA, Hochman JS, Roe MT, Chen AY, Chaudhry SI, Katz S, et al. The association of frailty with in-hospital bleeding among older adults with acute myocardial infarction: insights from the ACTION Registry. JACC Cardiovasc Interv 2018;11(22):2287–96.

Chen X, Mao G, Leng S. Frailty syndrome: an overview. Clin Interv Aging 2014;9:433–41.

O’Caoimh R, Sezgin D, O’Donovan MR, Molloy DW, Clegg A, Rockwood K, et al. Prevalence of frailty in 62 countries across the world: a systematic review and meta-analysis of population-level studies. Age Ageing 2021;50:96–104.

Anand A, Cudmore S, Robertson S, Stephen J, Haga K, Weir CJ, et al. Frailty assessment and risk prediction by GRACE score in older patients with acute myocardial infarction. BMC Geriatr 2020;20(1):102.

Patel A, Goodman SG, Yan AT, Alexander KP, Wong CL, Cheema AN, et al. Frailty and Outcomes After Myocardial Infarction: Insights from the CONCORDANCE Registry. J Am Heart Assoc 2018;7(18):e009859.

Ekerstad N, Javadzadeh D, Alexander KP, Bergström O, Eurenius L, Fredrikson M, et al. Clinical Frailty Scale classes are independently associated with 6-month mortality for patients after acute myocardial infarction. Eur Heart J Acute Cardiovasc Care 2022;11(2):89–98.

Singh M, Rihal CS, Lennon RJ, Spertus JA, Nair KS, Roger VL. Influence of frailty and health status on outcomes in patients with coronary disease undergoing percutaneous revascularization. Circ Cardiovasc Qual Outcomes 2011;4:496–502.

Fernando SM, McIsaac DI, Rochwerg B, Bagshaw SM, Muscedere J, Munshi L, et al. Frailty and invasive mechanical ventilation: association with outcomes, extubation failure, and tracheostomy. Intensive Care Med 2019;45(12):1742–52.

Kundi H, Wadhera RK, Strom JB, Valsdottir LR, Shen C, Kazi DS, et al. Association of Frailty With 30-Day Outcomes for Acute Myocardial Infarction, Heart Failure, and Pneumonia Among Elderly Adults. JAMA Cardiol 2019;4(11):1084–91.

Afilalo J, Alexander KP, Mack MJ, Maurer MS, Green P, Allen LA, et al. "Frailty assessment in the cardiovascular care of older adults". J Am Coll Cardiol 2014;63:747–62.

Muscedere J, Bagshaw SM, Boyd G, Sibley S, Norman P, Day A, et al. The frailty, outcomes, recovery and care steps of critically ill patients (FORECAST) study: pilot study results. Inten Care Med Exp 2022;10(1):23.

Veronese N, Cereda E, Stubbs B, Solmi M, Luchini C, Manzato E, 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. Ageing Res Rev 2017;35:63–73.

Jentzer JC, Bennett C, Wiley BM, Murphree DH, Keegan MT, Gajic O, et al. Predictive Value of the Sequential Organ Failure Assessment Score for Mortality in a Contemporary Cardiac Intensive Care Unit Population. J Am Heart Assoc 2018;7(6):e008169.

Elias A, Agbarieh R, Saliba W, Khoury J, Bahouth F, Nashashibi J, et al. SOFA score and short-term mortality in acute decompensated heart failure. Sci Rep 2020;10(1):20802.

Anand A, Cudmore S, Robertson S, Stephen J, Haga K, Weir CJ, et al. Frailty assessment and risk prediction by GRACE score in older patients with acute myocardial infarction. BMC Geriatr 2020;20(1):120.

Kojima G, Iliffe S, Jivraj S, Walters K. Association between frailty and quality of life among community-dwelling older people: a systematic review and meta-analysis. J Epidemiol Community Health 2016;70:716–21.

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Published

2024-02-05