Relationship of Physical Function and Social Frailty with Post-discharge Clinical Events in Patients with Cardiovascular Disease

Abstract

Objective：Physical function decline and social frailty are prognostic factors for cardiovascular disease；however, their combined effects remain to be examined. We aimed to investigate the association between post-discharge clinical events and the coexistence of decreased walking speed and social frailty or lack of caregivers in patients with cardiovascular disease.

Design：Retrospective cohort study.

Patients：Patients aged ≥65 years who participated in inpatient cardiac rehabilitation.

Methods：Patients were divided into four groups according to the presence of decreased walking speed (＜1.0 m/sec) and social frailty or lack of caregiver. The association with a composite event risk (mortality or rehospitalization) was evaluated using a multivariate Cox proportional hazards model.

Results：This study included 182 patients (median age：75 years). When stratified according to reduced walking speed and social frailty, those with decreased walking speed showed a higher event risk, which further increased with social frailty. When stratified by declining walking speed and lack of caregivers, those with both factors exhibited the highest risk of the event.

Conclusion：Decreased walking speed with social frailty or lack of caregivers was associated with a higher poor post-discharge outcome risk. Our findings highlight the importance of adjusting the environment for disease management, including using social resources, when planning rehabilitation interventions after discharge.