Why the study?
To determine independent associations between medicines with anticholinergic or sedative effects and frailty with length of stay, coronary artery procedures, and 30-day deaths in octogenarians admitted for MI.
Does frailty or the use of medicines with anticholinergic/sedative effects predict adverse outcomes in octogenarians admitted for MI?
Does frailty or the use of medicines with anticholinergic/sedative effects predict adverse outcomes in octogenarians admitted for MI?
Frailty, rather than the burden of anticholinergic or sedative medications, is a significant predictor of 30-day mortality and the likelihood of receiving coronary procedures in octogenarians with MI.
Answers are grounded in this paper and cite their sources.
High frailty risk may inform risk stratification in octogenarian MI; extends HFRS prognostic value over DBI but leaves open causal effects and interventions.
OBJECTIVE: To determine independent associations between the use of medicines with anticholinergic or sedative effects and frailty with outcomes of length of stay (LOS), coronary artery procedure performed and 30-day deaths in octogenarians admitted for a myocardial infarction (MI). METHODS: We quantified patient exposure to medicines with anticholinergic or sedative effects using the drug burden index (DBI) and frailty using the hospital frailty risk score (HFRS). We used multivariable regression methods to determine the association between DBI and HFRS with outcomes of LOS, coronary artery procedures performed and 30-day deaths. RESULTS: HFRS and not DBI score was significantly associated with receipt of coronary artery procedures (odds ratio [OR] 0.42; 95% CI 0.28-0.62 for high- versus low-risk groups) and 30-day deaths (OR 1.58; 95% CI 1.12-2.24 for high- versus low-risk groups). CONCLUSION: Frailty risk is a more important predictor of outcomes than DBI score for octogenarians with an MI.
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Lopez et al. (2020) studied this question.
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