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Abstract

Introduction

Frailty, independent of age, is associated with adverse outcomes following admission with Acute Coronary Syndrome (ACS) but is often not accounted for in risk stratification scores. Those identified as frail may not be considered for invasive interventions despite evidenced benefits (1) and are at risk of worsening geriatric syndromes on discharge.

Purpose

We aimed to assess clinical outcomes in older adults admitted with ACS, with or without frailty to suggest if there is a role for geriatrician input in improving healthcare usage and preventing adverse events.

Method

Anonymised data was obtained from an NHS trust’s MINAP registry of patients admitted with ACS between April 2022 to March 2023. Baseline demographics, Clinical Frailty Score (CFS), GRACE and HEART scores, total length of stay (LOS), days as inpatient pre- and post-procedure, adverse events during admission, readmission rates and all-cause mortality rate at 30 days and 1 year were calculated.

Results

288 patients over age 65 admitted with ACS were included in analysis. Median age was 73 [IQR 67–80.75]. Patients over 75 years had higher rates of frailty (38.5% of 75–84 years and 50.0% over 85 years had CFS ≥ 5 versus 14.9% 65–74 years (p < 0.00001)). 253 (87%) patients underwent invasive angiogram during admission. Although age was not a limiting factor, frail patients were less likely to have an angiogram: 24.9% of CFS ≥ 5 versus 57.1% of CFS ≤ 3 (p = 0.00199). Mean LOS was 9.02 days with a median of 7[IQR 4–12]. There was a trend for longer LOS post-angiogram particularly for patients with CFS 4–5 versus CFS ≤ 3 (11.3 days v 8.92 days p = 0.053).

Conclusions

Input from geriatricians and wider multidisciplinary team may help to optimise decision-making and care of patients admitted with ACS with mild to moderate frailty.

Reference

1. Damluji et al. J Am Heart Assoc. 2019;8:e013686.

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© The Author(s) 2025. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For permissions, please email: [email protected].
This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://dbpia.nl.go.kr/pages/standard-publication-reuse-rights)
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