Acute cardiac care & resuscitation
Association Between Frailty and Management and Outcomes of Acute Myocardial Infarction Complicated by Cardiogenic Shock
Main finding · In-hospital mortalityResult — go to the resultAdjusted odds ratio 2.17 95% CI 2.07–2.26Authors' conclusion
A high proportion of hospitalizations for AMI-CS had concomitant frailty. Hospitalizations with AMI-CS and frailty had higher rates of in-hospital morbidity and mortality compared to those without frailty.
Study context
- Population
- Hospitalizations for acute myocardial infarction (AMI) complicated by cardiogenic shock (AMI-CS), US National Inpatient Sample, 2016–2020
- Participants
- 283,700 hospitalizations
- Exposure
- Frail vs nonfrail AMI-CS hospitalizations
- Outcome
- In-hospital mortality
- Follow-up
- In-hospital
Methodological detailsNational Inpatient Sample 2016–2020
- National Inpatient Sample 2016–2020
Main finding
As reported in the abstract
Adjusted odds ratio
2.17
95% CI 2.07–2.26
P < 0.001
Frail vs Nonfrail
aOR 2.17 (95% CI 2.07–2.26); P < 0.001
Observational data: associations, not effects.
Further findings
| Outcome | aOR (95% CI) | P value | |
|---|---|---|---|
| Coronary revascularization | 0.55 (0.53–0.58) | P < 0.001 | |
| Mechanical circulatory support | 0.89 (0.85–0.93) | P < 0.001 | |
| 0.512Adjusted odds ratio (log scale) |
| Outcome | Frail | Nonfrail | |
|---|---|---|---|
| Frailty prevalence | 70.8% | Not reported in the abstract | Nonfrail: not reported in the abstract |
DNR status, discharge to skilled nursing facility
- Higher odds with frailty
AMI-CS hospitalizations trend · 2016 to 2020
- Increase from 53,210 in 2016 to 57,065 in 2020, driven by a rise in the frail
- P for trend < 0.001
Safety
In-hospital adverse events (intracranial hemorrhage, GI hemorrhage, AKI, delirium)
- Higher odds with frailty
Original publication
Association Between Frailty and Management and Outcomes of Acute Myocardial Infarction Complicated by Cardiogenic Shock. JACC Adv. Published 17 May 2024. doi:10.
Summarised from the published abstract; every number is checked against it