Diaz-Arocutipa Carlos, Hernandez Adrian V
Unidad de Revisiones Sistemáticas y Meta-análisis (URSIGET), Vicerrectorado de Investigación, Universidad San Ignacio de Loyola, Lima, Peru.
Health Outcomes, Policy, and Evidence Synthesis (HOPES) Group, University of Connecticut School of Pharmacy, Storrs, Connecticut, USA.
Clin Cardiol. 2025 Jan;48(1):e70054. doi: 10.1002/clc.70054.
There is scarce data on the prognostic value of frailty in patients with Takotsubo cardiomyopathy (TCM). This study aimed to assess the association between frailty and in-hospital outcomes in patients with TCM.
Adult admissions with TCM were included using the 2016-2019 National Inpatient Sample database. The primary outcome was in-hospital mortality and secondary outcomes included cardiogenic shock, in-hospital cardiac arrest, stroke/transient ischemic attack (TIA), length of hospital stay, and total charges. Frailty was assessed using the hospital frailty risk score (HFRS), and admissions were divided into two groups: low risk and intermediate/high risk of frailty. Logistic regression was used to estimate odds ratios (OR) with their 95% confidence intervals (CI).
A total of 32 360 patients were included; the median age was 67 (58-76) years and 90% were female. The median HFRS was 2.6 (1.1-5.3). In the adjusted models, in-hospital mortality was significantly higher in the intermediate/high risk of frailty group (OR 3.60, 95% CI 2.16-6.02) compared to the low-risk group. Similarly, admissions with intermediate/high risk of frailty had a significantly higher risk of cardiogenic shock (OR 3.66, 95% CI 2.77-4.80), in-hospital cardiac arrest (OR 2.57, 95% CI 1.55-4.24), and stroke/TIA (OR 5.68, 95% CI 3.51-9.20). There was a significantly higher hospital charges and length of hospital stay in the intermediate/high-risk group. In the restricted cubic spline regression models, the frailty score was nonlinearly associated with all outcomes.
Our results suggest that frailty is useful as a prognostic factor for in-hospital events in patients with TCM.
关于Takotsubo心肌病（TCM）患者中衰弱的预后价值的数据很少。本研究旨在评估TCM患者中衰弱与住院结局之间的关联。
使用2016 - 2019年国家住院样本数据库纳入成年TCM住院患者。主要结局是住院死亡率，次要结局包括心源性休克、院内心脏骤停、中风/短暂性脑缺血发作（TIA）、住院时间和总费用。使用医院衰弱风险评分（HFRS）评估衰弱情况，并将入院患者分为两组：低风险和中/高风险衰弱组。采用逻辑回归估计比值比（OR）及其95%置信区间（CI）。
共纳入32360例患者；中位年龄为67（58 - 76）岁，90%为女性。中位HFRS为2.6（1.1 - 5.3）。在调整模型中，与低风险组相比，中/高风险衰弱组的住院死亡率显著更高（OR 3.60，95% CI 2.16 - 6.02）。同样，中/高风险衰弱的入院患者发生心源性休克（OR 3.66, 95% CI 2.77 - 4.80）、院内心脏骤停（OR 2.57, 95% CI 1.55 - 4.24）和中风/TIA（OR 5.68, 95% CI 3.51 - 9.20）的风险显著更高。中/高风险组的住院费用和住院时间显著更长。在受限立方样条回归模型中，衰弱评分与所有结局均呈非线性关联。
我们的结果表明，衰弱可作为TCM患者住院事件的预后因素。
