Frailty and acute coronary syndrome: A structured literature review.

Frailty and acute coronary syndrome: A structured literature review.
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DOI:
10.1177/2048872617700873
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发表时间:
2018-03
期刊:
European heart journal. Acute cardiovascular care
影响因子:
--
通讯作者:
Gale CP
Gale CP
中科院分区:
其他
文献类型:
--
作者:
Bebb O;Smith FG;Clegg A;Hall M;Gale CP

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急性冠脉综合征(ACS)和虚弱的健康负担很高,但虚弱对ACS治疗和结果的影响尚不确定。在这篇结构化的文献综述中,我们调查了虚弱、ACS治疗和结果之间的关系。在2000年至2016年期间,我们只发现了少量调查虚弱和ACS护理的初步研究(n= 10)。虚弱与ACS后死亡率增加独立相关(虚弱患者调整后的全因死亡率风险比为1.54 - 5.39)。体弱多病的老年人接受指南指示的ACS治疗的可能性明显较低,包括经皮冠状动脉介入治疗(PCI)(发生率从6.7% -43.7% vs. 30.4%-69.5%)。PCI的现有数据表明,国际指南推荐的治疗方法与临床实践之间存在差距。进一步的研究是有必要的,以调查在急性环境中识别虚弱的方法,以及改善老年虚弱的ACS患者的护理机会。
The health burden of acute coronary syndrome (ACS) and frailty is high, but the impact of frailty on ACS treatment and outcomes is uncertain. In this structured literature review, we investigated the relationship between frailty, ACS treatment and outcomes. Between 2000 and 2016, we identified only a small number of primary research studies investigating frailty and ACS care (n= 10). Frailty was independently associated with increased mortality following ACS (adjusted all-cause mortality hazard ratios for patients with frailty ranged from 1.54 – 5.39). Older people with frailty were significantly less likely to receive guideline-indicated ACS care, including percutaneous coronary intervention (PCI) (Rates ranged from 6.7% -43.7% vs. 30.4%-69.5%). Available data for PCI indicated a gap between treatment recommended by international guidelines and clinical practice. Further research is warranted to investigate methods for identifying frailty in the acute setting and opportunities for improving care among older people with frailty presenting with ACS.
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