Background Frailty is increasingly present in patients with acute myocardial infarction. The electronic Frailty Index (eFI) is a validated method of identifying vulnerable older patients in the community from routine primary care data. Our aim was to assess the relationship between the eFI and outcomes in older patients hospitalised with acute myocardial infarction. Study design and setting Retrospective cohort study using the DataLoch Heart Disease Registry comprising consecutive patients aged 65 years or over hospitalised with a myocardial infarction between October 2013 and March 2021. Methods Patients were classified as fit, mild, moderate, or severely frail based on their eFI score. Cox-regression analysis was used to determine the association between frailty category and all-cause mortality. Results In 4670 patients (median age 77 years [71–84], 43% female), 1865 (40%) were classified as fit, with 1699 (36%), 798 (17%) and 308 (7%) classified as mild, moderate and severely frail, respectively. In total, 1142 patients died within 12 months of which 248 (13%) and 147 (48%) were classified as fit and severely frail, respectively. After adjustment, any degree of frailty was associated with an increased risk of all-cause death with the risk greatest in the severely frail (reference = fit, adjusted hazard ratio 2.87 [95% confidence intervals 2.24 to 3.66]). Conclusion The eFI identified patients at high risk of death following myocardial infarction. Automatic calculation within administrative data is feasible and could provide a low-cost method of identifying vulnerable older patients on hospital presentation.

中文翻译：

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心肌梗死患者的电子衰弱指数及结局


背景 急性心肌梗塞患者越来越多地出现虚弱症状。电子衰弱指数 (eFI) 是一种经过验证的方法，可根据常规初级保健数据识别社区中脆弱的老年患者。我们的目的是评估 eFI 与因急性心肌梗死住院的老年患者的结局之间的关系。研究设计和设置 使用 DataLoch 心脏病登记库进行回顾性队列研究，包括 2013 年 10 月至 2021 年 3 月期间因心肌梗塞住院的 65 岁或以上连续患者。 eFI 分数。 Cox 回归分析用于确定衰弱类别与全因死亡率之间的关联。结果 在 4670 名患者中（中位年龄 77 岁 [71-84]，43% 为女性），1865 名 (40%) 被归类为健康，1699 名 (36%)、798 名 (17%) 和 308 名 (7%) 被归类为健康分别为轻度、中度和重度虚弱。总共有 1142 名患者在 12 个月内死亡，其中 248 名患者（13%）和 147 名患者（48%）分别被归类为健康和严重虚弱。调整后，任何程度的虚弱都与全因死亡风险增加相关，其中严重虚弱的风险最大（参考=拟合，调整后的风险比2.87 [95%置信区间2.24至3.66]）。结论 eFI 识别出心肌梗死后死亡风险高的患者。管理数据中的自动计算是可行的，并且可以提供一种低成本的方法来识别医院就诊时的弱势老年患者。