Kohei Nozaki1, Kentaro Kamiya2, Nobuaki Hamazaki1, Hiroshi Saito3, Kazuya Saito4, Yuki Ogasahara5, Emi Maekawa6, Masaaki Konishi7, Takeshi Kitai8, Kentaro Iwata9, Kentaro Jujo10, Hiroshi Wada11, Takatoshi Kasai12, Hirofumi Nagamatsu13, Tetsuya Ozawa14, Katsuya Izawa15, Shuhei Yamamoto16, Naoki Aizawa17, Akihiro Makino18, Kazuhiro Oka19, Shin-Ichi Momomura20, Nobuyuki Kagiyama21, Yuya Matsue12. 1. Department of Rehabilitation, Kitasato University Hospital, Sagamihara, Japan. 2. Department of Rehabilitation, School of Allied Health Science, Kitasato University, Sagamihara, Japan. Electronic address: k-kamiya@kitasato-u.ac.jp. 3. Department of Rehabilitation, Kameda Medical Center, Kamogawa, Japan; Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan. 4. Department of Rehabilitation, The Sakakibara Heart Institute of Okayama, Okayama, Japan. 5. Department of Nursing, The Sakakibara Heart Institute of Okayama, Okayama, Japan. 6. Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Japan. 7. Division of Cardiology, Yokohama City University Medical Center, Yokohama, Japan. 8. Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital, Kobe, Japan. 9. Department of Rehabilitation, Kobe City Medical Center General Hospital, Kobe, Japan. 10. Department of Cardiology, Nishiarai Heart Center Hospital, Tokyo, Japan. 11. Department of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan. 12. Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan; Cardiovascular Respiratory Sleep Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan. 13. Department of Cardiology, Tokai University School of Medicine, Isehara, Japan. 14. Department of Rehabilitation, Odawara Municipal Hospital, Odawara, Japan. 15. Department of Rehabilitation, Kasukabe Chuo General Hospital, Kasukabe, Japan. 16. Department of Rehabilitation, Shinshu University Hospital, Matsumoto, Japan. 17. Department of Cardiovascular Medicine, Nephrology and Neurology, University of Ryukyus, Okinawa, Japan. 18. Department of Rehabilitation, Kitasato University Medical Center, Kitamoto, Japan. 19. Department of Rehabilitation, Saitama Citizens Medical Center, Saitama, Japan. 20. Saitama Citizens Medical Center, Saitama, Japan. 21. Department of Cardiology, The Sakakibara Heart Institute of Okayama, Okayama, Japan; West Virginia University Heart and Vascular Institute, Morgantown, WV, USA.
Abstract
OBJECTIVES: We investigated whether the FRAIL scale questionnaire is consistent with the Fried criteria, predicts all-cause mortality, and reflects physical dysfunction in patients with heart failure (HF). DESIGN: Secondary analysis of FRAGILE-HF, a cohort study that enrolled participants from 2016 to 2018 and followed-up for 1-year of discharge. SETTING AND PARTICIPANTS: A prospective multicenter cohort study in which 15 hospitals in Japan (8 university hospitals and 7 nonuniversity teaching hospitals) participated. We prospectively enrolled 1332 consecutive hospitalized patients ≥65 years old with HF and analyzed 1028 patients after excluding 304 patients with missing data on the FRAIL scale. METHODS: The FRAIL scale, the Fried model, and physical function were measured before discharge. The endpoint was all-cause mortality. RESULTS: According to the FRAIL scale, 459 (44.6%) and 491 (47.8%) were classified as frail and prefrail, respectively. The Kappa coefficient between the FRAIL scale and the Fried criteria were 0.39 [95% confidence interval (CI) 0.34-0.44; P < .001]. The area under the receiver-operating characteristic curves for frailty diagnosed by the Fried criteria of the FRAIL scale was 0.74 (95% CI 0.71-0.76; P < .001). A total of 118 deaths occurred during 1 year of follow-up. After adjusting for the MAGGIC risk score and log-BNP, The FRAIL scale predicted all-cause mortality (hazard ratio 1.17; 95% CI 1.01-1.36; P = .035). The FRAIL scale was also associated with various physical dysfunctions that correlated with poor prognosis. CONCLUSIONS AND IMPLICATIONS: The FRAIL scale had moderate consistency with the Fried criteria, predicted all-cause mortality, and reflected clinically important physical dysfunctions.
OBJECTIVES: We investigated whether the FRAIL scale questionnaire is consistent with the Fried criteria, predicts all-cause mortality, and reflects physical dysfunction in patients with heart failure (HF). DESIGN: Secondary analysis of FRAGILE-HF, a cohort study that enrolled participants from 2016 to 2018 and followed-up for 1-year of discharge. SETTING AND PARTICIPANTS: A prospective multicenter cohort study in which 15 hospitals in Japan (8 university hospitals and 7 nonuniversity teaching hospitals) participated. We prospectively enrolled 1332 consecutive hospitalized patients ≥65 years old with HF and analyzed 1028 patients after excluding 304 patients with missing data on the FRAIL scale. METHODS: The FRAIL scale, the Fried model, and physical function were measured before discharge. The endpoint was all-cause mortality. RESULTS: According to the FRAIL scale, 459 (44.6%) and 491 (47.8%) were classified as frail and prefrail, respectively. The Kappa coefficient between the FRAIL scale and the Fried criteria were 0.39 [95% confidence interval (CI) 0.34-0.44; P < .001]. The area under the receiver-operating characteristic curves for frailty diagnosed by the Fried criteria of the FRAIL scale was 0.74 (95% CI 0.71-0.76; P < .001). A total of 118 deaths occurred during 1 year of follow-up. After adjusting for the MAGGIC risk score and log-BNP, The FRAIL scale predicted all-cause mortality (hazard ratio 1.17; 95% CI 1.01-1.36; P = .035). The FRAIL scale was also associated with various physical dysfunctions that correlated with poor prognosis. CONCLUSIONS AND IMPLICATIONS: The FRAIL scale had moderate consistency with the Fried criteria, predicted all-cause mortality, and reflected clinically important physical dysfunctions.