Related Experiment Video
Updated: Aug 9, 2025
Author Spotlight: Assessing Surgical Frailty with Point-of-Care Ultrasound of Quadriceps Muscles
Published on: July 26, 2024
Impact of frailty on outcomes in acute ST-elevated myocardial infarctions undergoing percutaneous coronary
Joseph Heaton1, Sohrab Singh1, Dhairya Nanavaty1
1Department of Internal Medicine, The Brooklyn Hospital Center, Brooklyn, New York, USA.
Insights
Frailty significantly increases readmission risk and healthcare costs for ST-elevated myocardial infarction (STEMI) patients. Higher frailty scores correlate with lower rates of percutaneous coronary intervention (PCI) and longer hospital stays.
Area of Science:
- Cardiology
- Geriatrics
- Health Services Research
Background:
- Frailty is an emerging risk factor in cardiovascular disease.
- Understanding frailty's impact on ST-elevated myocardial infarction (STEMI) outcomes is crucial for patient management.
- Existing research has not fully elucidated frailty's association with readmission and treatment utilization in STEMI patients.
Purpose of the Study:
- To investigate the association between frailty and 30-day readmission rates in STEMI patients.
- To analyze the impact of frailty on the utilization of percutaneous coronary intervention (PCI) in STEMI admissions.
- To assess healthcare resource utilization across different frailty risk levels in STEMI patients.
Main Methods:
- Analysis of the 2016-2019 Nationwide Readmission Database for acute STEMI admissions.
- Categorization of patients into low, intermediate, and high frailty risk groups using the hospital frailty risk score.
- Evaluation of 30-day readmission risk, PCI utilization, and healthcare resource utilization (length of stay, cost, discharge disposition).
Main Results:
- Frailty was independently associated with increased 30-day readmission risk (intermediate: 1.37x, high: 1.21x).
- PCI utilization decreased significantly with increasing frailty risk (low: 86.40%, intermediate: 66.03%, high: 58.90%).
- Higher frailty risk correlated with longer length of stay, increased total cost, and higher likelihood of skilled facility discharge.
Conclusions:
- Frailty, as assessed by the hospital frailty risk score, is a significant predictor of adverse outcomes in STEMI patients.
- Increased frailty is linked to higher readmission rates and greater healthcare resource utilization.
- Frailty assessment should be integrated into STEMI care pathways to optimize treatment and resource allocation.
Aims:
We analyzed the impact of frailty on readmission rates for ST-elevated myocardial infarctions (STEMIs) and the utilization of percutaneous coronary intervention (PCI) in STEMI admissions.
Methods And Results:
The 2016-2019 Nationwide Readmission Database was analyzed for patients admitted with an acute STEMI. Patients were categorized by frailty risk and analyzed for 30-day readmission risk after acute STEMIs, PCI utilization and outcomes, and healthcare resource utilization. Qualifying index admissions were found in 584,918 visits. Low risk frailty was noted in 78.20%, intermediate risk in 20.67%, and high risk in 1.14% of admissions. Thirty-day readmissions occurred in 7.74% of index admissions, increasing with frailty (p < 0.001). Readmission risk increased with frailty, 1.37 times with intermediate and 1.21 times with high-risk frailty. PCI was performed in 86.40% of low-risk, 66.03% of intermediate-risk, and 58.90% of high-risk patients (p < 0.001). Intermediate patients were 55.02% less likely and high-risk patients were 61.26% less likely to undergo PCI (p < 0.001). Length of stay means for index admissions were 2.96, 7.83, and 16.32 days for low, intermediate, and high-risk groups. Intermediate and high-risk frailty had longer length of stay, higher total cost, and were more likely to be discharged to a skilled facility (p < 0.001).
Conclusion:
Among adult, all-payer inpatient visits, frailty discerned by the hospital frailty risk score was associated with increased readmissions, increased healthcare resource utilization, and lower PCI administration.
More Related Videos
05:41Left Anterior Descending Coronary Artery Ligation for Ischemia-Reperfusion Research: Model Improvement via Technical Modifications and Quality Control
Published on: December 16, 2022
05:53Measuring Frailty in HIV-infected Individuals. Identification of Frail Patients is the First Step to Amelioration and Reversal of Frailty
Published on: July 24, 2013
Related Concept Videos
01:30Acute Coronary Syndrome I: Introduction
01:28Acute Coronary Syndrome IV: Interprofessional Care
01:30Acute Coronary Syndrome III: Diagnostic Studies
01:19Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations
01:26Acute Coronary Syndrome V: Nursing Management
01:27Coronary Artery Disease V: Interprofessional Care