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Purpose of Review <p>Percutaneous Coronary Intervention (PCI) is a common treatment for coronary artery disease. With an increasing number of elderly patients undergoing PCI, there is a need for better pre-procedural risk stratification tools. Frailty has been identified as an independent predictor of adverse outcomes following PCI. This study evaluates the impact of frailty, as measured by the Risk Analysis Index (RAI), on in-hospital outcomes, including mortality, prolonged hospitalization, non-home discharge, and perioperative complications, using data from The National Inpatient Sample (NIS) from 2016 to 2020.</p> Recent Findings <p>This retrospective cohort study analyzed 449,857 PCI admissions from 2016 to 2020 and found that increasing frailty scores were associated with worse post-PCI outcomes. Stratification based on the RAI categorized patients as robust (22.6%), pre-frail (54.9%), frail (19%), and very frail (3.5%). Higher frailty scores correlated with increased extended length of stay (eLOS) (robust: 11.42% vs. very frail: 54.33%), non-home discharge (NHD) (robust: 7.64% vs. very frail: 61.54%), and mortality (robust: 1.25% vs. very frail: 7.06%). The RAI effectively predicted NHD (C-statistic 0.73) and showed moderate accuracy in predicting eLOS and mortality. Additionally, frailty was significantly associated with higher rates of periprocedural complications such as cardiac arrest, stroke, acute kidney injury, major bleeding, vasopressor use, and invasive mechanical ventilation.</p> Summary <p>Frailty, as assessed by the RAI, was independently associated with adverse in-hospital outcomes in PCI patients, including higher mortality, longer hospitalizations, non-home discharge, and increased perioperative complications. These findings highlight the importance of incorporating frailty assessment into preoperative risk stratification to guide clinical decision-making and improve patient counseling.</p>

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Role of Frailty as Measured by the Risk Analysis Index (RAI) to Predict In-Hospital and Perioperative Outcomes in Patients Undergoing PCI: a Nationwide Study

  • 期刊论文

  • 发表日期：

    2025年8月8日

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  • Michele Fouad,
  • Ahmad Nawlo,
  • Kerollos Abdelsayed,
  • Hassan Alshaker,
  • Kirellos Said Abbas,
  • Abdul Rahman Akkawi,
  • Basel Abdelazeem,
  • Akram Kawsara

摘要

Purpose of Review

Percutaneous Coronary Intervention (PCI) is a common treatment for coronary artery disease. With an increasing number of elderly patients undergoing PCI, there is a need for better pre-procedural risk stratification tools. Frailty has been identified as an independent predictor of adverse outcomes following PCI. This study evaluates the impact of frailty, as measured by the Risk Analysis Index (RAI), on in-hospital outcomes, including mortality, prolonged hospitalization, non-home discharge, and perioperative complications, using data from The National Inpatient Sample (NIS) from 2016 to 2020.

Recent Findings

This retrospective cohort study analyzed 449,857 PCI admissions from 2016 to 2020 and found that increasing frailty scores were associated with worse post-PCI outcomes. Stratification based on the RAI categorized patients as robust (22.6%), pre-frail (54.9%), frail (19%), and very frail (3.5%). Higher frailty scores correlated with increased extended length of stay (eLOS) (robust: 11.42% vs. very frail: 54.33%), non-home discharge (NHD) (robust: 7.64% vs. very frail: 61.54%), and mortality (robust: 1.25% vs. very frail: 7.06%). The RAI effectively predicted NHD (C-statistic 0.73) and showed moderate accuracy in predicting eLOS and mortality. Additionally, frailty was significantly associated with higher rates of periprocedural complications such as cardiac arrest, stroke, acute kidney injury, major bleeding, vasopressor use, and invasive mechanical ventilation.

Summary

Frailty, as assessed by the RAI, was independently associated with adverse in-hospital outcomes in PCI patients, including higher mortality, longer hospitalizations, non-home discharge, and increased perioperative complications. These findings highlight the importance of incorporating frailty assessment into preoperative risk stratification to guide clinical decision-making and improve patient counseling.