MỐI LIÊN QUAN GIỮA SUY YẾU VÀ BIẾN CỐ XUẤT HUYẾT NỘI VIỆN TRÊN BỆNH NHÂN CAO TUỔI ĐƯỢC CAN THIỆP MẠCH VÀNH QUA DA TẠI BỆNH VIỆN THỐNG NHẤT

Abstract

Objective: To evaluate the association between frailty and in-hospital bleeding events among older adults undergoing percutaneous coronary intervention at Thong Nhat hospital. Subjects and Methods: A prospective short-term cohort study enrolled patients aged ≥60 years undergoing percutaneous coronary intervention at the Department of Emergent and Interventional Cardiology, Thong Nhat Hospital, from August 2024 to August 2025. Frailty status was evaluated using the Clinical Frailty Scale (CFS), while in-hospital bleeding events were categorized according to the BARC classification. Statistical analyses were conducted with SPSS software, version 27.0 (IBM Corp., Armonk, NY, USA). Results: Among 305 patients enrolled between August 2024 and August 2025 at the Department of Emergent and Interventional Cardiology, Thong Nhat Hospital, the incidence of in-hospital bleeding was 16.1%. Frailty (CFS ≥4) and periprocedural UFH dose (IU/kg) were significantly associated with bleeding events. Frailty was independently associated with in-hospital bleeding (OR: 2.30; 95% CI: 1.06–4.95; p = 0.035). Stratified analysis demonstrated that both very mild/mild frailty (OR: 2.14; 95% CI: 1.00–4.56; p = 0.049) and moderate-to-severe frailty (OR: 7.27; 95% CI: 2.38–22.27; p < 0.001) were independent predictors compared with non-frail patients. The incidence of bleeding increased progressively with frailty severity (fit/well: 9.1%; very mild/mild: 17.6%; moderate/severe: 42.1%). Additionally, higher periprocedural UFH dose was an independent predictor of in-hospital bleeding (OR: 1.04; 95% CI: 1.02–1.07; p = 0.001). Conclusion: Frailty independently predicts in-hospital bleeding after PCI in older adults, emphasizing the necessity of frailty assessment to guide individualized anticoagulation strategies and improve procedural safety.