Prognostic Value of Frailty in Patients With Takotsubo Cardiomyopathy.

IF 2.4 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Clinical Cardiology Pub Date : 2025-01-01 DOI:10.1002/clc.70054

Carlos Diaz-Arocutipa, Adrian V Hernandez

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Abstract

Background: There is scarce data on the prognostic value of frailty in patients with Takotsubo cardiomyopathy (TCM). This study aimed to assess the association between frailty and in-hospital outcomes in patients with TCM.

Methods: Adult admissions with TCM were included using the 2016-2019 National Inpatient Sample database. The primary outcome was in-hospital mortality and secondary outcomes included cardiogenic shock, in-hospital cardiac arrest, stroke/transient ischemic attack (TIA), length of hospital stay, and total charges. Frailty was assessed using the hospital frailty risk score (HFRS), and admissions were divided into two groups: low risk and intermediate/high risk of frailty. Logistic regression was used to estimate odds ratios (OR) with their 95% confidence intervals (CI).

Results: A total of 32 360 patients were included; the median age was 67 (58-76) years and 90% were female. The median HFRS was 2.6 (1.1-5.3). In the adjusted models, in-hospital mortality was significantly higher in the intermediate/high risk of frailty group (OR 3.60, 95% CI 2.16-6.02) compared to the low-risk group. Similarly, admissions with intermediate/high risk of frailty had a significantly higher risk of cardiogenic shock (OR 3.66, 95% CI 2.77-4.80), in-hospital cardiac arrest (OR 2.57, 95% CI 1.55-4.24), and stroke/TIA (OR 5.68, 95% CI 3.51-9.20). There was a significantly higher hospital charges and length of hospital stay in the intermediate/high-risk group. In the restricted cubic spline regression models, the frailty score was nonlinearly associated with all outcomes.

Conclusions: Our results suggest that frailty is useful as a prognostic factor for in-hospital events in patients with TCM.

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虚弱在Takotsubo心肌病患者中的预后价值。

背景：虚弱对Takotsubo心肌病（TCM）患者预后价值的研究资料较少。本研究旨在评估中医患者虚弱与住院预后之间的关系。方法：使用2016-2019年全国住院患者样本数据库纳入成人中医住院患者。主要结局是院内死亡率，次要结局包括心源性休克、院内心脏骤停、中风/短暂性脑缺血发作（TIA）、住院时间和总费用。使用医院虚弱风险评分（HFRS）评估虚弱，并将入院患者分为两组：低风险组和中/高风险组。采用Logistic回归估计比值比（OR）及其95%置信区间（CI）。结果：共纳入32 360例患者；中位年龄为67（58 ~ 76）岁，90%为女性。HFRS中位数为2.6（1.1-5.3）。在调整后的模型中，中/高风险虚弱组的住院死亡率显著高于低风险组（OR 3.60, 95% CI 2.16-6.02）。同样，中/高危体弱入院患者发生心源性休克（OR 3.66, 95% CI 2.77-4.80）、院内心脏骤停（OR 2.57, 95% CI 1.55-4.24）和卒中/TIA （OR 5.68, 95% CI 3.51-9.20）的风险明显更高。中高危组的住院费用和住院时间明显高于高危组。在受限三次样条回归模型中，虚弱评分与所有结果呈非线性相关。结论：我们的研究结果表明，虚弱是中医患者院内事件的一个有用的预后因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Cardiology 医学-心血管系统

CiteScore

5.10

自引率

3.70%

发文量

189

审稿时长

4-8 weeks

期刊介绍： Clinical Cardiology provides a fully Gold Open Access forum for the publication of original clinical research, as well as brief reviews of diagnostic and therapeutic issues in cardiovascular medicine and cardiovascular surgery. The journal includes Clinical Investigations, Reviews, free standing editorials and commentaries, and bonus online-only content. The journal also publishes supplements, Expert Panel Discussions, sponsored clinical Reviews, Trial Designs, and Quality and Outcomes.