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衰弱及其他老年综合征对非ST段抬高型急性冠脉综合征老年患者临床管理及预后的影响:LONGEVO-SCA注册研究的原理与设计

Impact of Frailty and Other Geriatric Syndromes on Clinical Management and Outcomes in Elderly Patients With Non-ST-Segment Elevation Acute Coronary Syndromes: Rationale and Design of the LONGEVO-SCA Registry.

作者信息

Alegre Oriol, Ariza-Solé Albert, Vidán María T, Formiga Francesc, Martínez-Sellés Manuel, Bueno Héctor, Sanchís Juan, López-Palop Ramón, Abu-Assi Emad, Cequier Àngel

机构信息

Bellvitge University Hospital, University of Barcelona, Barcelona, Spain.

Hospital General Universitario Gregorio Marañón, Universidad Europea y Universidad Complutense de Madrid, Madrid, Spain.

出版信息

Clin Cardiol. 2016 Jul;39(7):373-7. doi: 10.1002/clc.22550. Epub 2016 Jun 30.

Abstract

The incidence of acute coronary syndromes (ACS) is high in the elderly. Despite a high prevalence of frailty and other aging-related variables, little information exists about the optimal clinical management in patients with coexisting geriatric syndromes. The aim of the LONGEVO-SCA registry (Impacto de la Fragilidad y Otros Síndromes Geriátricos en el Manejo y Pronóstico Vital del Anciano con Síndrome Coronario Agudo sin Elevación de Segmento ST) is to assess the impact of aging-related variables on clinical management, prognosis, and functional status in elderly patients with ACS. A series of 500 consecutive octogenarian patients with non-ST-segment elevation ACS from 57 centers in Spain will be included. A comprehensive geriatric assessment will be performed during the admission, assessing functional status (Barthel Index, Lawton-Brody Index), frailty (FRAIL scale, Short Physical Performance Battery), comorbidity (Charlson Index), nutritional status (Mini Nutritional Assessment-Short Form), and quality of life (Seattle Angina Questionnaire). Patients will be managed according to current recommendations. The primary outcome will be the description of mortality and its causes at 6 months. Secondary outcomes will be changes in functional status and quality of life. Results from this study might significantly improve the knowledge about the impact of aging-related variables on management and outcomes of elderly patients with ACS. Clinical management of these patients has become a major health care problem due to the growing incidence of ACS in the elderly and its particularities.

摘要

急性冠状动脉综合征(ACS)在老年人中的发病率很高。尽管虚弱及其他与衰老相关的变量普遍存在,但关于合并老年综合征患者的最佳临床管理的信息却很少。LONGEVO-SCA注册研究(老年虚弱及其他综合征对老年急性非ST段抬高型冠状动脉综合征患者治疗及生存预后的影响)的目的是评估与衰老相关的变量对老年ACS患者临床管理、预后及功能状态的影响。将纳入来自西班牙57个中心的500例连续的80岁及以上非ST段抬高型ACS患者。入院期间将进行全面的老年综合评估,评估功能状态(Barthel指数、Lawton-Brody指数)、虚弱程度(FRAIL量表、简短体能状况量表)、合并症(Charlson指数)、营养状况(简易营养评估简表)及生活质量(西雅图心绞痛问卷)。患者将按照当前指南进行管理。主要结局将是6个月时的死亡率及其原因描述。次要结局将是功能状态和生活质量的变化。这项研究的结果可能会显著提高我们对与衰老相关的变量对老年ACS患者管理和结局影响的认识。由于老年人中ACS发病率不断上升及其特殊性,这些患者的临床管理已成为一个主要的医疗保健问题。

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