Incremental Value of Objective Frailty Assessment to Predict Mortality in Elderly Patients Hospitalized for Heart Failure.
J Card Fail. 2018 Jul 12;:
Authors: Tanaka S, Kamiya K, Hamazaki N, Matsuzawa R, Nozaki K, Maekawa E, Noda C, Yamaoka-Tojo M, Matsunaga A, Masuda T, Ako J
BACKGROUND: The impact of frailty on long-term prognosis in patients with heart failure (HF) remains unclear, and there is no simple and objective assessment for it. This study was performed to examine the association between frailty score and clinical outcome in elderly patients hospitalized for HF.
METHODS AND RESULTS: A retrospective cohort study was performed in 603 elderly patients with HF (mean age: 75±6 years, 378 men; 62.7%). Frailty was measured by a composite of four markers combined into a frailty score (possible range 0-12): gait speed, handgrip strength, serum albumin, and activities of daily living status. The patient population was divided into two groups with frailty score <5 (non-frail) or ≥5 (frail). The endpoint was all-cause mortality. Over a mean follow-up period of 1.7±0.5 years, 89 patients died. Following adjustment for several pre-existing factors associated with prognosis, the frailty score (hazard ratio [HR]: 1.11; p=0.014) and frailty (HR: 1.75; p=0.036) were independently associated with all-cause mortality. The inclusion of frailty score significantly increased both continuous net reclassification improvement (0.341; p=0.002) and integrated discrimination improvement (0.016; p=0.039) for all-cause mortality.
CONCLUSIONS: A simple and objective frailty score was associated with health outcome in elderly patients hospitalized for HF.
PMID: 30010026 [PubMed - as supplied by publisher]