The effect of frailty in older community-dwelling outpatients with atrial fibrillation: a new score HAS-BLED-F (rail)
A. Tufan, Y. Yildiz, N. Şentürk Durmuş, B. Can, C. Ilgin, B. İlhan Department of Internal Medicine, Divisions of Geriatrics, Marmara University Medical School, Pendik, Istanbul, Turkey. aslitufan@yahoo.com
OBJECTIVE: This study aims to determine the effect of frailty on thromboembolic events (TEE) and bleeding in older patients with non-valvular atrial fibrillation (AF).
PATIENTS AND METHODS: Patients aged ≥65 years who were diagnosed as having non-valvular AF in a geriatric outpatient clinic between June 2015 and February 2021 were included in the study. Frailty, the risk of thrombosis secondary to AF, and the risk of bleeding as a complication of AF treatment were evaluated using the FRAIL scale, and CHA2DS2-VASc and HAS-BLED scores, respectively.
RESULTS: Out of 83 patients included in the study, 72.3% were frail and 21.7% were pre-frail. TEE was observed in 14.5% (n=12) and bleeding was observed in 25.3% (n=21) of the patients. A total of 21 (25.3%) patients had a history of bleeding. There was no difference between the normal, pre-frail, and frail groups in terms of TEE and bleeding history (p=0.112 and p=0.571, respectively). In multivariate analysis, mortality decreased with the use of apixaban; frailty and malnutrition were found to increase mortality (p=0.014, p=0.023, and p=0.020, respectively). HAS-BLED-F score was obtained as a result of the sum of the patients’ HAS-BLED and FRAIL scores to predict the bleeding risk. A HAS-BLED-F score of ≥6 predicted the risk of bleeding with 90.5% sensitivity and 40.3% specificity.
CONCLUSIONS: Frailty is not associated with a statistically significant increase in the risk of thromboembolic events or bleeding in patients with non-valvular AF. HAS-BLED-F score can be used to better predict the risk of bleeding in frail patients.
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To cite this article
A. Tufan, Y. Yildiz, N. Şentürk Durmuş, B. Can, C. Ilgin, B. İlhan
The effect of frailty in older community-dwelling outpatients with atrial fibrillation: a new score HAS-BLED-F (rail)
Eur Rev Med Pharmacol Sci
Year: 2023
Vol. 27 - N. 7
Pages: 2919-2926
DOI: 10.26355/eurrev_202304_31923