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Recommendations of the Geriatric Cardiology Section of the Spanish Society of Cardiology for the Assessment of Frailty in Elderly Patients With Heart Disease

Published on Jan 1, 2019in Revista Espanola De Cardiologia5.13
· DOI :10.1016/j.rec.2018.06.035
Pablo Díez-Villanueva7
Estimated H-index: 7
,
Albert Ariza-Solé11
Estimated H-index: 11
+ 8 AuthorsManuel Martínez-Sellés21
Estimated H-index: 21
(Complutense University of Madrid)
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Abstract
Abstract Frailty is an age-associated clinical syndrome characterized by a decrease in physiological reserve in situations of stress, constituting a state of vulnerability that involves a higher risk of adverse events. Its prevalence in Spain is high, especially in elderly individuals with comorbidity and chronic diseases. In cardiovascular disease, frailty is associated worse clinical outcomes and higher morbidity and mortality in all scenarios, in both acute and chronic settings, and could consequently influence diagnosis and treatment. However, frailty is often not addressed or included when planning the management of elderly patients with heart disease. In this article, we review the available scientific evidence and highlight the most appropriate scales for the measurement and assessment of frailty, some of which are more useful and have better predictive capacity than others, depending on the clinical context. We also underline the importance of properly identifying and assessing frailty in order to include it in the treatment and care plan that best suits each patient.
  • References (66)
  • Citations (2)
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References66
Newest
Published on Feb 1, 2019in Revista Espanola De Cardiologia5.13
Juan Alberto Sanchis Llopis35
Estimated H-index: 35
(University of Valencia),
Albert Ariza-Solé11
Estimated H-index: 11
+ 28 AuthorsBruno García del Blanco24
Estimated H-index: 24
Abstract Introduction and objectives Although clinical guidelines recommend invasive management in non–ST-segment elevation myocardial infarction (NSTEMI), this strategy is underused in frail elderly patients in the real world. Furthermore, these patients are underrepresented in clinical trials and therefore the evidence is scarce. Our hypothesis is that an invasive strategy will improve prognosis in elderly frail patients with NSTEMI. Methods This will be a prospective, multicenter, randomized ...
David Walker8
Estimated H-index: 8
(East Sussex County Council),
Chris P Gale31
Estimated H-index: 31
(University of Leeds)
+ 9 AuthorsC Wilkinson1
Estimated H-index: 1
(University of Leeds)
Frailty is increasingly seen among patients with acute cardiovascular disease. A combination of an ageing population, improved disease survival, treatable long-term conditions as well as a greater recognition of the syndrome has accelerated the prevalence of frailty in the modern world. Yet, this has not been matched by an expansion of research. National and international bodies have identified acute cardiovascular disease in the frail as a priority area for care and an entity that requires care...
Published on Mar 1, 2018in Thrombosis and Haemostasis4.73
Albert Ariza-Solé11
Estimated H-index: 11
,
Carme Guerrero3
Estimated H-index: 3
+ 19 AuthorsMaría Teresa Vidán16
Estimated H-index: 16
Background Bleeding risk scores have shown a limited predictive ability in elderly patients with acute coronary syndromes (ACS). No study explored the role of a comprehensive geriatric assessment to predict in-hospital bleeding in this clinical setting. Methods The prospective multicentre LONGEVO-SCA registry included 532 unselected patients with non-ST segment elevation ACS (NSTEACS) aged 80 years or older. Comorbidity (Charlson index), frailty (FRAIL scale), disability (Barthel index and Lawto...
Published on Feb 1, 2018in Heart Lung and Circulation2.08
Eva Bernal3
Estimated H-index: 3
(Autonomous University of Barcelona),
Albert Ariza-Solé11
Estimated H-index: 11
+ 5 AuthorsManuel Martínez-Sellés21
Estimated H-index: 21
(Complutense University of Madrid)
Background The number of nonagenarian patients with aortic stenosis will likely increase due to the ageing population. We assessed the clinical characteristics, management, and outcomes of nonagenarian patients with severe aortic stenosis. Methods A total of 177 (117 females and 60 males) consecutive nonagenarian patients from two large contemporary registries were included in this study. Clinical characteristics, comorbidity as assessed by the Charlson Index, clinical management, and outcomes w...
Published on Dec 1, 2017in Current Opinion in Cardiology1.98
George A. Heckman24
Estimated H-index: 24
,
Robert S. McKelvie58
Estimated H-index: 58
,
Kenneth Rockwood83
Estimated H-index: 83
Published on Nov 1, 2017in Revista Espanola De Cardiologia5.13
Pablo Díez-Villanueva7
Estimated H-index: 7
,
Albert Ariza-Solé11
Estimated H-index: 11
+ 3 AuthorsManuel Martínez-Sellés21
Estimated H-index: 21
(Complutense University of Madrid)
Oriol Alegre4
Estimated H-index: 4
,
Francesc Formiga25
Estimated H-index: 25
+ 61 AuthorsJaime Aboal1
Estimated H-index: 1
Abstract Background Information about the impact of frailty in patients with acute coronary syndromes (ACS) is scarce. No study has assessed the prognostic impact of frailty as measured by the FRAIL scale in very elderly patients with ACS. Methods The prospective multicenter LONGEVO-SCA registry included unselected patients with ACS aged 80 years or older. A comprehensive geriatric assessment was performed during hospitalization, including frailty assessment by the FRAIL scale. The primary endpo...
Published on Sep 12, 2017in Cochrane Database of Systematic Reviews7.75
Graham Ellis10
Estimated H-index: 10
(Monklands Hospital),
Michael P. Gardner15
Estimated H-index: 15
(University of Oxford)
+ 11 AuthorsIngvild Saltvedt21
Estimated H-index: 21
(NTNU: Norwegian University of Science and Technology)
Background Comprehensive geriatric assessment (CGA) is a multi-dimensional, multi-disciplinary diagnostic and therapeutic process conducted to determine the medical, mental, and functional problems of older people with frailty so that a co-ordinated and integrated plan for treatment and follow-up can be developed. This is an update of a previously published Cochrane review. Objectives We sought to critically appraise and summarise current evidence on the effectiveness and resource use of CGA for...
Cited By2
Newest
Published on May 1, 2019in Revista Espanola De Cardiologia5.13
Teresa López-Fernández8
Estimated H-index: 8
(Hospital Universitario La Paz),
Teresa López-Fernández3
Estimated H-index: 3
+ 29 AuthorsConcepción Alonso-Martín17
Estimated H-index: 17
Resumen La mejora en la supervivencia de los pacientes con cancer ha puesto de manifiesto el impacto clinico que la cardiotoxicidad tiene en el pronostico tanto cardiovascular como onco-hematologico, sobre todo cuando motiva la interrupcion de terapias antitumorales altamente eficaces. La fibrilacion auricular es una complicacion frecuente en pacientes con cancer activo y su tratamiento supone un gran reto. Estos pacientes tienen mayores riesgos tromboembolico y hemorragico y, sin embargo, no se...
Pablo Díez-Villanueva7
Estimated H-index: 7
(UAM: Autonomous University of Madrid),
Jorge Salamanca4
Estimated H-index: 4
(UAM: Autonomous University of Madrid)
+ 9 AuthorsCésar Jiménez Méndez (UAM: Autonomous University of Madrid)
Resumen Antecedentes y objetivos La insuficiencia cardiaca (IC) es una enfermedad cronica frecuentemente asociada al envejecimiento. Disponemos de modelos predictivos basados en variables que asocian mal pronostico y que sin embargo no incluyen condiciones habituales en el paciente mayor, como la fragilidad o la comorbilidad. Nuestro objetivo es conocer las caracteristicas clinicas y epidemiologicas de una cohorte de pacientes mayores con IC ambulatoria seguidos por cardiologia, la prevalencia d...
Published on 2019in Revista Espanola De Cardiologia5.13
Teresa López-Fernández8
Estimated H-index: 8
(Hospital Universitario La Paz),
Ana Martín-García4
Estimated H-index: 4
+ 7 AuthorsMeritxell Arenas12
Estimated H-index: 12
Abstract Improvements in survival among cancer patients have revealed the clinical impact of cardiotoxicity on both cardiovascular and hematological and oncological outcomes, especially when it leads to the interruption of highly effective antitumor therapies. Atrial fibrillation is a common complication in patients with active cancer and its treatment poses a major challenge. These patients have an increased thromboembolic and hemorrhagic risk but standard stroke prediction scores have not been...
Published on Aug 1, 2019in Revista Espanola De Cardiologia5.13
José Manuel García-Pinilla13
Estimated H-index: 13
,
Pablo Díez-Villanueva7
Estimated H-index: 7
+ 11 AuthorsCristina Enjuanes Grau
Resumen La insuficiencia cardiaca es una entidad compleja, que conlleva elevada morbilidad y mortalidad y cuyo curso y evolucion son inciertos y dificiles de predecir. Este trabajo, impulsado por las Secciones de Insuficiencia Cardiaca y Cardiologia Geriatrica de la Sociedad Espanola de Cardiologia, aborda los diferentes aspectos relacionados con los cuidados paliativos en el campo de la insuficiencia cardiaca, via final comun de la mayoria de las enfermedades cardiovasculares. Tambien establece...
View next paperFrailty assessment in the cardiovascular care of older adults