Frailty Trajectories and Determinants in Older Adults After PCI: A Longitudinal Study

老年患者经皮冠状动脉介入治疗后衰弱轨迹及决定因素:一项纵向研究

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Abstract

AIM: To identify distinct frailty trajectories and their determinants in older adults during the first six months after percutaneous coronary intervention (PCI), guided by the Health Ecology Model. DESIGN: A prospective observational design. METHODS: This study investigated the frailty status of elderly patients who underwent PCI surgery at a tertiary hospital in Ningxia, China, from November 2023 to May 2024, within six months after discharge. The Latent Growth Mixture Model was utilized to identify trajectories of frailty and classify participants based on these trajectories. Then, multivariable logistic regression analysis was employed to analyze the predictive factors of different trajectories. The reporting of this study adhered to the STROBE checklist. RESULTS: 218 elderly patients completed follow-up after PCI. There were three frailty trajectories among elderly people after PCI: the Low-Ascending Group (32.6%), the Middle-Alleviation Group (37.6%), and the High-Fluctuating Group (29.8%). Multivariate logistic regression analysis showed that depression, self-efficacy, occupation, NYHA class, and types of medication were influencing factors of their frailty trajectories (P<0.05). CONCLUSION: The high proportion of frailty among elderly individuals after PCI should be a cause for concern. Additionally, targeted interventions based on frailty trajectories and measures like depression screening, self-efficacy support, and polypharmacy management are needed to address frailty in elderly post-PCI patients. IMPACT: This study highlights the importance of tracking the frailty status of elderly patients after PCI, providing a new perspective and theoretical basis for healthcare professionals to design personalized and targeted intervention plans to prevent or ameliorate frailty. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution. The study only included patients who were research participants.

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