What is the clinical evidence from this study?

Study design: Cohort. Population: Cardiovascular disease (n=336). Intervention: Kihon Checklist (KCL) score ≥ 8 vs. Kihon Checklist (KCL) score < 8. Primary outcome: All-cause death (HR 2.731, 95% CI 1.202-6.205, p=0.016).

What question did this study set out to answer?

To verify the association between Kihon checklist scores and the prognosis of older adults suffering from cardiovascular disease.

April 1, 2026Open Access

Prognostic Value of the Kihon Checklist in Older Cardiovascular Disease Patients

Q: What are the key findings of this study?

A Kihon Checklist score of 8 or higher was significantly associated with an increased risk of all-cause death (HR 2.73) and cardiovascular death (HR 2.88) in older adults with cardiovascular disease.

Q: What question did this study set out to answer?

To verify the association between Kihon checklist scores and the prognosis of older adults suffering from cardiovascular disease.

Key Result

A Kihon Checklist score of 8 or higher was significantly associated with an increased risk of all-cause death (HR 2.73) and cardiovascular death (HR 2.88) in older adults with cardiovascular disease.

Key Points

To verify the association between Kihon checklist scores and the prognosis of older adults suffering from cardiovascular disease.
Utilized the Kihon checklist to assess frailty in older adults with cardiovascular disease.
Analyzed the relationship between KCL scores and health outcomes.
Involved older adults diagnosed with cardiovascular disease.
Identified a significant correlation between KCL scores and prognosis.
Lower KCL scores were associated with improved health outcomes.
Higher KCL scores indicated increased frailty and worse prognosis.

Study Design

Type

Cohort (n=336)

Multicenter

Structured PICO

Does a Kihon checklist score of 8 or higher predict all-cause death in older adults hospitalized for cardiovascular disease?

Population

336 older adults (aged ≥65 years, mean age 80.7, 53.0% male) admitted for worsening cardiovascular disease (including structural heart disease such as angina pectoris and acute coronary syndrome without HF, and worsening HF) to a single center in Japan. Key exclusions: severe respiratory dysfunction, liver dysfunction (Child-Pugh C), renal dysfunction (eGFR G5), malignant tumors, stroke, MMSE <18, and living in a nursing care facility.

Intervention

Kihon checklist (KCL) score ≥ 8 (indicating frailty)

Comparator

Kihon checklist (KCL) score < 8

Outcome

All-cause deathhard clinical

The Kihon checklist is a practical frailty assessment tool where a score of 8 or higher independently predicts all-cause and cardiovascular mortality in older adults hospitalized for cardiovascular disease.

Main Result

Effect estimate: HR 2.731 (95% CI 1.202-6.205)

Absolute Event Rate: 19.3% vs 5.8%

p-value: p=0.016

Limitations

Single-center study
Small sample size
Low incidence of adverse events limiting the number of prognostic indicators in multivariable analysis
Need for further studies to investigate the relationship between individual KCL sub-items and prognosis

Abstract

Objectives: Of various frailty indicators, none are suitable for cardiovascular disease (CVD). We aimed to verify the association between the Kihon checklist (KCL) score and prognosis of older adults with CVD.

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