Fried Frailty Phenotype in Elderly Patients with Chronic Coronary Syndrome: Prevalence, Associated Factors, and Impact on Hospitalization

Purpose: To investigate the prevalence and factors associated with frailty and impact of frailty on hospitalization due to any cause in elderly patients with chronic coronary syndrome (CCS). Patients and Methods: We conducted a study wherein we assessed frailty using Fried frailty phenotype for outpatients aged >= 60 years with CCS. Logistic regression analysis was performed to assess the factors associated with frailty. Frailty was adjusted for demographic and geriatric variables and comorbidities to assess its impact on hospitalization. Results: Overall, 420 patients (median age 70 years [interquartile range, 65- 77]; men, 74.5%) who completed the 3-month follow-up period were analyzed. Coronary revascularization for > 1 year was the most common clinical scenario for CCS (59.8%; n = 251). The prevalence of non-frail, pre-frail, and frail patients were 22.4% (n = 94), 49.7% (n = 209), and 27.9% (n = 117), respectively. In the adjusted model, three factors associated with frailty were age >= 75 years (odds ratio [OR] 2.29, 95% confidence interval [CI] 1.39- 3.75, P = 0.001), limitations in instrumental activity of daily living (OR 3.89, 95% CI 2.33- 6.48, P < 0.001), and heart failure (OR 2.30, 95% CI 1.32- 4.02, P = 0.003). The overall 3-month hospitalization rate was higher in frail patients than in non-frail patients (23.9% vs 13.5%, P = 0.012). Frailty was associated with hospitalization (OR 1.85, 95% CI 1.04- 3.30, P = 0.037) but in a weak strength of association (r = 0.126). Conclusion: The prevalence of frailty was 27.9% in the elderly patients with CCS. Age >= 75 years, limitations in functional status, and heart failure were associated with increased odds of frailty. Frailty was a predictor of 3-month all-cause hospitalization in these patients.