VES-13 identified frailty in 40.2% of HF outpatients and showed stronger prediction of mortality (HR 3.70) and composite endpoint (HR 3.13) than multimodal assessment.
Does the VES-13 frailty screening tool predict adverse prognosis better than a multimodal assessment in heart failure outpatients?
The VES-13 is a simple frailty tool that outperforms comprehensive multimodal assessments in predicting mortality and heart failure hospitalizations in HF outpatients.
Absolute Event Rate: 0% vs 0%
Background Frailty is common and significantly impacts prognosis in heart failure (HF). The Vulnerable Elders Survey-13 (VES-13), widely used in oncogeriatrics and public health, remains unexplored as a frailty screening tool in HF outpatients. In this study, we prospectively evaluated VES-13 against a multimodal screening assessment in detecting frailty and predicting individual risk of adverse prognosis. Methods Frailty was assessed at the initial visit using both a multimodal approach, incorporating Barthel Index, Older American Resources and Services scale, Pfeiffer Test, abbreviated Geriatric Depression Scale, age > 85 years, lacking support systems, and VES-13. Patients scoring ≥ 3 on VES-13 or meeting at least one multimodal criterion were classified as frail. Endpoints included all-cause mortality, a composite of death or HF hospitalization, and recurrent HF hospitalizations. Results A total of 301 patients were evaluated. VES-13 identified 40.2% as frail and the multimodal assessment 33.2%. In Cox regression analyses, frailty identified by VES-13 showed greater prognostic significance than the multimodal assessment for all-cause mortality (HR = 3.70 2.15–6.33, P vs. 2.40 1.46–4.0, P = 0.001) and the composite endpoint (HR = 3.13 2.02–4.84, P vs. 1.96 1.28–2.99, P = 0.002). Recurrent HF hospitalizations were four times more frequent in VES-13 frail patients while two times in those identified as frail by the multimodal assessment. Additionally, stratifying patients by VES-13 tertiles provided robust risk differentiation. Conclusions VES-13, a simple frailty tool, outperformed a comprehensive multimodal assessment and could be easily integrated into routine HF care, highlighting its clinical utility in identifying patients at risk for poor outcomes.
Roig et al. (Thu,) reported a other. VES-13 identified frailty in 40.2% of HF outpatients and showed stronger prediction of mortality (HR 3.70) and composite endpoint (HR 3.13) than multimodal assessment.