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Frailty as a Predictor of In-Hospital Outcomes in Patients Undergoing Percutaneous Coronary Intervention for Chronic

Lourdes Vicent1,2, Rafael Salguero-Bodes1,2,3, Roberto Martín-Asenjo1,2

  • 1Department of Cardiology, Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), 28041 Madrid, Spain.

Journal of Clinical Medicine
|July 12, 2025
PubMed

Insights

Frailty significantly increases the risk of in-hospital complications, including mortality and adverse events, for patients undergoing percutaneous coronary intervention for chronic total occlusion (CTO-PCI). Early frailty assessment can improve patient risk stratification and care.

Area of Science:

  • Cardiology
  • Geriatrics
  • Health Services Research

Background:

  • Limited data exists on the prognostic implications of frailty in patients undergoing percutaneous coronary intervention (PCI) for chronic total occlusion (CTO).
  • Understanding frailty's impact is crucial for managing high-risk patient populations undergoing complex cardiovascular procedures.

Purpose of the Study:

  • To investigate the association between frailty and in-hospital complications in patients undergoing CTO-PCI.
  • To evaluate the predictive value of the Hospital Frailty Risk Score (HFRS) in this specific patient group.

Main Methods:

  • Retrospective cohort study utilizing the National Inpatient Sample (NIS) database (2016-2019).
  • Frailty assessed using the Hospital Frailty Risk Score (HFRS), categorized into low (<5), intermediate (5-15), and high (>15) risk groups.
  • Logistic regression models used to determine odds ratios (ORs) and 95% confidence intervals (CIs) for in-hospital complications.

Main Results:

  • The study included 46,695 patients undergoing CTO-PCI.
  • High-risk frailty patients demonstrated significantly higher odds of in-hospital mortality (OR 9.51), blood transfusion (OR 4.78), pericardial complications (OR 16.0), and renal replacement therapy (OR 3.83) compared to low-risk patients.
  • Intermediate-risk frailty patients also showed increased odds for most adverse outcomes.

Conclusions:

  • Frailty is a significant independent predictor of in-hospital complications following CTO-PCI.
  • Routine frailty assessment in patients undergoing CTO-PCI can enhance risk stratification.
  • Tailored care strategies based on frailty status are recommended for this high-risk population.

Keywords:
chronic total occlusioncoronary artery diseasefrailtypercutaneous coronary intervention

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