Affiliation:
1. Department of Critical Care Medicine Mayo Clinic Jacksonville Florida USA
2. Department of Medicine, Mount Sinai Morningside and Mount Sinai West Icahn School of Medicine at Mount Sinai New York New York USA
3. Department of Medicine University of Panama Panama City Panama
4. Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery Mayo Clinic Jacksonville Florida USA
Abstract
AimThis study aims to evaluate the impact of frailty on the outcomes of older patients with pulmonary embolism (PE).MethodsUsing the National Inpatient Sample database, we identified 288 070 patients aged 65 or older who were admitted with a primary diagnosis of PE from 2017 to 2019. Frailty was assessed using the Hospital Frailty Risk Score (HFRS), and patients were categorized into low‐, intermediate‐, and high‐frailty‐risk groups. Multivariate logistic regression was used to calculate adjusted odds ratios for all outcomes.ResultsThese patients were categorized into low‐risk (57.6%, 161 420), medium‐risk (39.9%, 111 805), and high‐risk (2.5%, 7075) groups. High‐risk patients, predominantly females with multiple comorbidities, exhibited significantly higher mortality rates and adverse outcomes. The HFRS showed a good discriminating ability in predicting mortality (area under the receiver operating characteristic curve = 0.7796). Frailty was associated with increased use of advanced therapeutic interventions and critical care resources such as thrombolysis, catheter‐directed therapies, inferior vena cava filter placement, mechanical ventilation, vasopressor use, and intensive care unit admission.ConclusionFrailty markedly affects outcomes in older PE patients. The HFRS offers a valuable prognostic tool in this population, suggesting that integrating frailty assessments into clinical practice could enhance care strategies and improve patient outcomes. Our findings underscore the need for further research to refine frailty‐based care paradigms. Geriatr Gerontol Int 2024; ••: ••–••.