Prognostic Value of Frailty in Patients With Takotsubo Cardiomyopathy.

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.