The Changes in Frailty and Death within Six Months of Discharge in Heart Failure Patients 80 Years and Older

Abstract

Aim : The prognostic impact of frailty in patients with heart failure (HF) is of interest because the cascade of frailty and HF accelerates deterioration. However, few studies have examined the deterioration of frailty in older HF patients. Therefore, we examined changes in frailty and death within six months after discharge from the hospital to clarify the reasons for the poor prognoses and to explore risk factors that influence each of them.
Methods : This was a single-center prospective cohort study of hospitalized HF patients aged 80≧ years. Frailty was measured using the Clinical Frailty Scale (CFS). Reasons for poor prognosis were examined, and discharge attributes were compared between the CFS worsening and death groups and the CFS maintaining/improving group at six months after discharge.
Results : The subjects consisted of 96 patients (89.3±4.6 years), and their CFS at six months was that 68 had improved or maintained, 12 had worsened, 14 had died, and two were missing. Reasons for worsening frailty included worsening cardiovascular disease and comorbidities, fall fracture, and dementia. Risk factors that could influence mortality (e.g., BNP, hemoglobin, CFS) were similar to previous studies, and few risk factors were found that could influence frailty deterioration (e.g., ACE-I/ARB not prescribed).
Conclusions : Some older HF patients experience worsening of frailty and death after hospital discharge. However, the potential factors associated with frailty deterioration are unknown, suggesting that treatment and care approaches should be tailored to individual conditions such as cardiovascular diseases, comorbidities, fall risk, and dementia.