2021 Volume 85 Issue 8 Pages 1341-1348
Background:Although patients with poor ability to perform activities of daily living, such as those with high Clinical Frailty Score (CFS), will often receive a cardiac implantable electric device (CIED), the indications for implantation in these patients have not been clearly defined. We investigated the association between CFS and prognosis in patients with a CIED.
Methods and Results:We retrospectively enrolled 323 consecutive patients who underwent initial device implantation (age, 77 (70–83) years; male, 181 [56%] patients; high-voltage device, 49 [15%] patients), and the CFS was retrospectively estimated. Primary outcome was all-cause death, and the secondary outcome was hospitalization due to heart failure (HF). Median CFS was 4 (3–5) points. During 2 years’ follow-up, all-cause death occurred in 32 patients (10%). Freedom from all-cause death was significantly lower in patients with a high CFS than in those with a low score (1–2 points: 100%, 3–4 points: 92.9%, 5–9 points: 77.3%, P<0.01). After adjustment for age and sex, the CFS was an independent predictor of the primary outcome (hazard ratio [HR] 2.0, 95% confidence interval [CI] 1.6–2.5, P<0.01), and of the secondary outcome (HR 1.6 [95% CI 1.2–2.0], P<0.01).
Conclusions:The CFS is an independent predictor of both death and hospitalization due to HF in patients with a CIED.
