Heart failure & cardiomyopathiesCohort study
Prognostic Impact of Frailty at Admission and in-Hospital Changes of Frailty Status in Elderly Patients with Acute Heart Failure
- Retrospective cohort study
- single-centre
- AHF-COR Registry
Authors' conclusion
Frailty is an independent prognostic marker of increased mortality risk in patients with AHF. Improvement of frailty status during hospitalization reduces mortality risk while worsening of frailty increases mortality risk.
Study context
- Population
- Hospitalized acute HF patients ≥65 years, tertiary hospital in Vienna, 2012–2019; frailty assessed by nursing staff at admission and dischargemean age 81 ± 8 years
- Participants
- 2,619 patients
- Exposure
- Moderate and severe frailty vs no frailty at admission
- Outcome
- All-cause mortality
- Follow-up
- 1 year
Main finding
As reported in the abstract
1-year mortality
Each group vs non-frailtyAdjusted hazard ratio (95% CI)P value
Moderate frailty
1.89(1.60–2.23)
P < 0.001Severe frailty
2.91(2.36–3.59)
P < 0.001Observational data: associations, not effects.
Further findings
| Outcome | adjusted HR (95% CI) | P value | |
|---|---|---|---|
| 1-year mortality by in-hospital change in frailty status — Improvement in frailty vs Non-frailty | 0.65 (0.49–0.88) | P < 0.001 | |
| 1-year mortality by in-hospital change in frailty status — Worsening of frailty vs Non-frailty | 3.18 (2.07–4.91) | P < 0.001 | |
| 0.20.5125Adjusted hazard ratio (log scale) |
28-day and 5-year mortality
- Similar results for 28-day and 5-year mortality risk
GDMT in HFrEF by frailty
- GDMT prescription decreased with increasing frailty but was associated with reduced mortality regardless of frailty status
- pfrailty-interaction = 0.592
Original publication
Prognostic Impact of Frailty at Admission and in-Hospital Changes of Frailty Status in Elderly Patients with Acute Heart Failure. Eur J Heart Fail. Published 25 July 2025. doi:10.1002/ejhf.3779
Summarised from the published abstract; every number is checked against it