The association between self-reported frailty status and 1-year all-cause mortality and readmission following PCI: A prospective multi-centre cohort study, CONCARD^PCI

Background: In older adults with ischemic heart disease, frailty status may better reflect biological than chronological age. The objective was to investigate the association between self-reported frailty status at discharge and a composite endpoint of 1-year mortality or all-cause readmission after percutaneous coronary intervention (PCI). Methods: A multi-centre prospective cohort study of patients undergoing PCI. Self-reported frailty status was assessed using the Study of Osteoporotic Fractures (SOF) Frailty Index (“robust”, “prefrail”, and “frail”). The association between frailty status and the composite endpoint was investigated using Cox regression analysis in adjusted models (Model 1 sociodemographic, Model 2 + clinical variables), reported as hazard ratios (HR) and 95 % confidence intervals (CI). Results: In total, 2831 patients (median age 66 years IQR 57–73, 21 % women) reported their frailty status post-PCI: 18 % were frail, 33 % prefrail, and 48 % robust. Among frail patients, a higher proportion (45 %) experienced the composite endpoint during the 1-year follow-up (vs robust 33 % and prefrail 35 %). Frailty status was not significantly associated with the composite endpoint. Post-hoc exploratory analyses showed that the SOF question about unintended weight loss was significantly associated with the composite endpoint among frail patients (adjHR 1.19 95 % CI 1.02–1.38 Model 1, adjHR 1.20 95 % CI 1.03–1.40 Model 2), driven by readmissions. Chair rise was associated with reduced mortality (Model 2 HR 0.32 95 % CI 0.11–0.92). Conclusion: Frailty status was not associated with the composite endpoint of 1-year mortality or readmission. However, unintended weight loss might be an important prognostic indicator for readmission and chair rise for mortality.