Prognostic Value of the Kihon Checklist in Older Cardiovascular Disease Patients

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. Methods: Participants (n = 336) were adults with CVD (aged ≥ 65 years, mean age 81 years) who required hospitalization. They were assessed with the KCL, and data were obtained for left ventricular ejection fraction (LVEF) and brain natriuretic peptide (BNP) at discharge, and the occurrence of all-cause death, CVD composite endpoint, CVD death, and CVD hospitalization after discharge. The cutoff value of the KCL score for all-cause death was calculated using receiver operating characteristic analysis, and participants were divided into two groups. The relationship between KCL score and prognosis was examined using survival time (Kaplan-Meier method) and Cox proportional hazards analyses. Results: The KCL cutoff value was 8 (KCL < 8, n=155). Survival time analysis showed significant differences in all-cause death, CVD composite endpoint, and CVD death (log-rank test: P < 0.001, each). Cox proportional hazards analysis showed that KCL score of 8 or higher was significantly associated with all-cause death [hazard ratio (HR), 2.731; 95% confidence interval (CI), 1.202-6.205] and CVD death (HR, 2.875; 95% CI, 1.124-7.353). In the HF only group, KCL score of 8 or higher was not significantly associated with all-cause death, CVD death, or CVD composite endpoint. Conclusions: Total KCL score was associated with mortality in the overall cohort of older adults with CVD, although the association in the HF subgroup alone showed a borderline trend.