title: The Impact of Frailty on Mortality, Length of Stay and Re-hospitalisation in Older Patients with Atrial Fibrillation.
abstract: BACKGROUND
  Frailty has been found to be associated with increased adverse outcomes in older patients, especially in patients with cardiovascular diseases. There has been no study focussing on the prognostic value of frailty amongst older hospitalised patients with atrial fibrillation. This study aims to investigate the impact of frailty on mortality, length of stay and re-hospitalisation in older hospitalised patients with atrial fibrillation.
  
  
  METHODS
  Prospective observational study in patients aged ≥65 years with atrial fibrillation admitted to a teaching hospital in Sydney, Australia. Frailty was assessed using the Reported Edmonton Frail Scale. Participants were followed up for six months for adverse outcomes.
  
  
  RESULTS
  We recruited 302 patients (mean age 84.7±7.1, 53.3% frail, 50% female). Frailty was associated with prolonged length of stay and increased mortality but not re-admission during six months after discharge. The coexistence of frailty and delirium significantly increased the risk of mortality.
  
  
  CONCLUSIONS
  Frailty is a common geriatric syndrome in older inpatients with atrial fibrillation and is associated with poor outcomes. Screening for frailty along with other clinically important factors like delirium should be considered in older patients with atrial fibrillation to optimise individualised treatment plans.
authors.affiliation: Departments of Clinical Pharmacology and Aged Care, Royal North Shore Hospital and Kolling Institute of Medical Research, Sydney Medical School, University of Sydney, Sydney, NSW, Australia; Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia. Electronic address: nngu9517@uni.sydney.edu.au.
authors.forename: Tu N
authors.initials: TN
authors.lastname: Nguyen
authors.affiliation: Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia.
authors.forename: Robert G
authors.initials: RG
authors.lastname: Cumming
authors.affiliation: Departments of Clinical Pharmacology and Aged Care, Royal North Shore Hospital and Kolling Institute of Medical Research, Sydney Medical School, University of Sydney, Sydney, NSW, Australia.
authors.forename: Sarah N
authors.initials: SN
authors.lastname: Hilmer
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000401:mortality / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D016330:Frail Elderly; D006801:Humans; D007902:Length of Stay; D008297:Male; D010359:Patient Readmission; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors
keywords: Adverse outcomes; Atrial fibrillation; Frailty; Mortality