Heart failure & cardiomyopathies
Prognostic Impact of Frailty Based on a Comprehensive Frailty Assessment in Patients with Heart Failure
Main finding · All-cause deathResult — go to the resultAdjusted hazard ratio 2.917 95% CI 1.326–6.417Authors' conclusion
The KCL is a useful tool for risk stratification of adverse outcomes in patients with AHF. Functional declines in psycho-emotional domains including cognitive function and depressed mood contribute to adverse outcomes.
Study context
- Population
- Patients hospitalized for acute heart failure (HF), Japan, May 2017 to December 2019 (Kochi YOSACOI)936 assessed for frailty
- Participants
- 1,061 patients
- Exposure
- Frail vs prefrail vs non-frail
- Frailn = 501
- Prefrailn = 290
- Non-frailn = 145reference
- Outcome
- All-cause death
- Follow-up
- 2 year
Methodological detailsmulticentre
- Multicentre
Main finding
All-cause death · 2 years
Adjusted hazard ratio
2.917
95% CI 1.326–6.417
P = 0.008
Frailty vs Non-frail
adjusted HR 2.917 (95% CI 1.326–6.417); P = 0.008
As reported in the abstract
- Higher incidence of all-cause death in frail patients
- log-rank P < 0.001
Observational data: associations, not effects.
Secondary outcomes
| Outcome | Adjusted HR (95% CI) | P value | |
|---|---|---|---|
| CV death · 2 year follow-up · multivariate analysis | 7.026 (1.700–29.030) | P = 0.007 | |
| All-cause death by total KCL score (per increase) | 1.819 (1.300–2.547) | P < 0.001 | |
| 0.050.21520Adjusted hazard ratio (log scale) |
Discharge to home
- CV death — Higher incidence in frail patients (log-rank)
- P < 0.001
- Discharge to home: P < 0.001
HF rehospitalization · 2 year follow-up
- Higher incidence in frail patients (log-rank)
- P = 0.003
- Depression domain of Kihon Checklist (KCL) associated with higher risk
- P = 0.045
KCL cognitive function domain
- Associated with higher risk of all-cause death
- P = 0.004
- Associated with higher risk of CV death
- P < 0.001
Original publication
Prognostic Impact of Frailty Based on a Comprehensive Frailty Assessment in Patients with Heart Failure. ESC Heart Fail. Published 28 March 2024. doi:10.
Summarised from the published abstract; every number is checked against it