The frailty syndrome is associated with adverse health outcomes in very old patients with stable heart failure: a prospective study in six Spanish hospitals

Rodríguez-Pascual, Carlos, Paredes-Galán, Emilio, Ferrero-Martínez, Ana-Isabel, Gonzalez-Guerrero, Jose-Luis, Hornillos-Calvo, Mercedes, Menendez-Colino, Rocio, Torres-Torres, Ivett, Vilches-Moraga, Arturo, Galán, Maria-Concepcion, Suarez-Garcia, Francisco, Olcoz-Chiva, Maria-Teresa and Rodríguez-Artalejo, Fernando (2017) The frailty syndrome is associated with adverse health outcomes in very old patients with stable heart failure: a prospective study in six Spanish hospitals. International Journal of Cardiology, 236 . pp. 296-303. ISSN 0167-5273

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Abstract

BACKGROUND:
Most studies on the association between the frailty syndrome and adverse health outcomes in patients with heart failure (HF) have used non-standard definitions of frailty. This study examined the association of frailty, diagnosed by well-accepted criteria, with mortality, readmission and functional decline in very old ambulatory patients with HF.

METHODS:
Prospective study with 497 patients in six Spanish hospitals and followed up during one year. Mean (SD) age was 85.2 (7.3) years, and 79.3% had LVEF >45%. Frailty was diagnosed as having ≥3 of the 5 Fried criteria. Readmission was defined as a new episode of hospitalisation lasting >24h, and functional decline as an incident limitation in any activity of daily living at the 1-year visit. Statistical analyses were performed with Cox and logistic regression, as appropriate, and adjusted for the main prognostic factors at baseline.

RESULTS:
At baseline, 57.5% of patients were frail. The adjusted hazard ratio (95% confidence interval) for mortality among frail versus non-frail patients was 1.93 (1.20-3.27). Mortality was higher among patients with low physical activity [1.64 (1.10-2.45)] or exhaustion [1.83 (1.21-2.77)]. Frailty was linked to increased risk of readmission [1.66 (1.17-2.36)] and functional decline [odds ratio 1.67 (1.01-2.79)]. Slow gait speed was related to functional decline [odds ratio 3.59 (1.75-7.34)]. A higher number of frailty criteria was associated with a higher risk of the three study outcomes (P trend<0.01 in each outcome).

CONCLUSIONS:
Frailty was associated with increased risk of 1-year mortality, hospital readmission and functional decline among older ambulatory patients with HF

Keywords:Frailty, Heart failure, Mortality, Readmission, Functional decline, Elderly
Subjects:A Medicine and Dentistry > A300 Clinical Medicine
Divisions:College of Science > School of Pharmacy
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ID Code:27704
Deposited On:05 Jul 2017 11:46

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