title: Role of frailty assessment in patients undergoing cardiac interventions.
abstract: Average life expectancy is increasing in the western world resulting in a growing number of frail individuals with coronary heart disease, often associated with comorbidities. Decisions to proceed to invasive interventions in elderly frail patients is challenging because they may gain benefit, but are also at risk of procedure-related complications. Current risk scores designed to predict mortality in cardiac procedures are mainly based on clinical and angiographic factors, with limitations in the elderly because they are mainly derived from a middle-aged population, do not account for frailty and do not predict the impact of the procedure on quality of life which often matters more to elderly patients than mortality. Frailty assessment has emerged as a measure of biological age that correlates well with quality of life, hospital admissions and mortality. Potentially, the incorporation of frailty into current risk assessment models will cause a shift towards more appropriate care. The need for a more accurate method of risk stratification incorporating frailty, particularly for elderly patients is pressing. This article reviews the association between frailty and cardiovascular disease, the impact of frailty on outcomes of cardiac interventions and suggests ways in which frailty assessment could be incorporated into cardiology clinical practice.
authors.affiliation: Department of Cardiovascular Science , University of Sheffield , Sheffield , UK ; Department of Cardiology , Northern General Hospital , Sheffield , UK.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Rowe
authors.affiliation: Department of Cardiovascular Science , University of Sheffield , Sheffield , UK ; Department of Cardiology , Northern General Hospital , Sheffield , UK.
authors.forename: Javaid
authors.initials: J
authors.lastname: Iqbal
authors.affiliation: Department of Cardiovascular Science , University of Sheffield , Sheffield , UK.
authors.forename: Rachel
authors.initials: R
authors.lastname: Murali-Krishnan
authors.affiliation: Department of Cardiology , Northern General Hospital , Sheffield , UK.
authors.forename: Ayyaz
authors.initials: A
authors.lastname: Sultan
authors.affiliation: Department of Cardiology , Northern General Hospital , Sheffield , UK.
authors.forename: Rachel
authors.initials: R
authors.lastname: Orme
authors.affiliation: Department of Cardiothoracic Surgery , Northern General Hospital , Sheffield , UK.
authors.forename: Norman
authors.initials: N
authors.lastname: Briffa
authors.affiliation: Centre for Cardiovascular Science, University of Edinburgh , Edinburgh , UK.
authors.forename: Martin
authors.initials: M
authors.lastname: Denvir
authors.affiliation: Department of Cardiovascular Science , University of Sheffield , Sheffield , UK ; Department of Cardiology , Northern General Hospital , Sheffield , UK.
authors.forename: Julian
authors.initials: J
authors.lastname: Gunn