Association of Frailty with Adverse Outcomes in Patients with Critical Acute Myocardial Infarction: A Retrospective Cohort Study

Weimin Bai,1,* Taoke Huang,2,* Xinying Li,3,* Weiyang Gao,2 Ji Qin,2 Yongxin Bian,4 Weihao Xu,5 Juan Xu,6 Lijie Qin1 1Department of Emergency, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, People’s Hospital of Henan University, Zhengzhou, 463599, People’s Republic of China; 2Medical School of Chinese PLA, Beijing, 100853, People’s Republic of China; 3Faculty of Postgraduate Education, Shandong Sport University, Jinan, 250102, People’s Republic of China; 4The First School of Clinical Medicine, Binzhou Medical University, Yantai, 264003, People’s Republic of China; 5Haikou Cadre’s Sanitarium of Hainan Military Region, Haikou, 570203, People’s Republic of China; 6Department of General Surgery, Affiliated Xiaoshan Hospital, Hangzhou Normal University, Hangzhou, 311202, People’s Republic of China*These authors contributed equally to this workCorrespondence: Juan Xu; Lijie Qin, Email sophia2932@163.com; qinlijie1819@163.comBackground: Frailty is a risk factor for acute myocardial infarction (AMI). This study examined the association between the modified frailty index (MFI) and adverse outcomes in patients with critical AMI.Methods: Data were obtained from the Medical Information Mart for Intensive Care IV database. Logistic and Cox regression models and a competing risk model were applied.Results: Of 5003 patients, 1496 were non-frail and 3507 were frail. Frailty was significantly associated with in-hospital mortality (per point, OR 1.13, 95% CI: 1.05– 1.21; frail vs non-frail, OR 1.31, 95% CI: 1.04– 1.65) and 1-year mortality (per point, HR 1.15, 95% CI: 1.11– 1.20; frail vs non-frail, HR 1.37, 95% CI: 1.20– 1.58). Frailty was significantly associated with post-discharge care needs (per point, OR 1.23, 95% CI: 1.14– 1.33; frail vs non-frail, OR 1.47, 95% CI: 1.22– 1.78). In the competing risk models, frailty was significantly associated with a lower probability of being disch