Shinya Tanaka1, Kentaro Kamiya2, Nobuaki Hamazaki3, Ryota Matsuzawa3, Kohei Nozaki3, Emi Maekawa4, Chiharu Noda4, Minako Yamaoka-Tojo5, Atsuhiko Matsunaga5, Takashi Masuda5, Junya Ako6. 1. Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kitasato University, Sagamihara, Japan. 2. Department of Rehabilitation, School of Allied Health Sciences, Kitasato University, Sagamihara, Japan. Electronic address: k-kamiya@kitasato-u.ac.jp. 3. Department of Rehabilitation, Kitasato University Hospital, Sagamihara, Japan. 4. Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Japan. 5. Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kitasato University, Sagamihara, Japan; Department of Rehabilitation, School of Allied Health Sciences, Kitasato University, Sagamihara, Japan. 6. Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kitasato University, Sagamihara, Japan; Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Japan.
Abstract
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 with 603 elderly patients with HF (mean age 75 ± 6 years, 378 [62.7%] men). Frailty was measured by a composite of 4 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 2 groups with frailty score <5 (non-frail) or ≥5 (frail). The end point was all-cause mortality. Over a mean follow-up period of 1.7 ± 0.5 years, 89 patients died. After adjustment for several preexisting factors associated with prognosis, the frailty score (hazard ratio [HR] 1.11; P = .014) and frailty (HR 1.75; P = .036) were independently associated with all-cause mortality. The inclusion of frailty score significantly increased both continuous net reclassification improvement (0.341; P = .002) and integrated discrimination improvement (0.016; P = .039) for all-cause mortality. CONCLUSIONS: A simple and objective frailty score was associated with health outcome in elderly patients hospitalized for HF.
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 with 603 elderly patients with HF (mean age 75 ± 6 years, 378 [62.7%] men). Frailty was measured by a composite of 4 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 2 groups with frailty score <5 (non-frail) or ≥5 (frail). The end point was all-cause mortality. Over a mean follow-up period of 1.7 ± 0.5 years, 89 patients died. After adjustment for several preexisting factors associated with prognosis, the frailty score (hazard ratio [HR] 1.11; P = .014) and frailty (HR 1.75; P = .036) were independently associated with all-cause mortality. The inclusion of frailty score significantly increased both continuous net reclassification improvement (0.341; P = .002) and integrated discrimination improvement (0.016; P = .039) for all-cause mortality. CONCLUSIONS: A simple and objective frailty score was associated with health outcome in elderly patients hospitalized for HF.
Authors: Quin E Denfeld; Beth A Habecker; S Albert Camacho; Mary Roberts Davis; Nandita Gupta; Shirin O Hiatt; Mary E Medysky; Jonathan Q Purnell; Kerri Winters-Stone; Christopher S Lee Journal: Circ Heart Fail Date: 2021-08-25 Impact factor: 10.447
Authors: Mary Roberts Davis; Christopher S Lee; Amy Corcoran; Nandita Gupta; Izabella Uchmanowicz; Quin E Denfeld Journal: Int J Cardiol Date: 2021-02-28 Impact factor: 4.039
Authors: Iván José Fuentes-Abolafio; Brendon Stubbs; Luis Miguel Pérez-Belmonte; María Rosa Bernal-López; Ricardo Gómez-Huelgas; Antonio Ignacio Cuesta-Vargas Journal: BMC Cardiovasc Disord Date: 2020-12-09 Impact factor: 2.298
Authors: Izabella Uchmanowicz; Christopher S Lee; Cristiana Vitale; Stanisław Manulik; Quin E Denfeld; Bartosz Uchmanowicz; Joanna Rosińczuk; Marcin Drozd; Joanna Jaroch; Ewa A Jankowska Journal: ESC Heart Fail Date: 2020-09-21