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June 5, 2020European Journal of Heart FailureOpen Access

Prevalence and Prognostic Impact of the Coexistence of Multiple Frailty Domains in Elderly Patients with Heart Failure: The FRAGILE-HF Cohort Study

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Key result

Three frailty domains linked to ~104% higher risk of 1-year HF readmission or death.

  • HR 2.04
  • 95% CI 1.28-3.24
  • P=0.003
  • n=1,180

Why the study?

The prevalence, overlap, and prognostic implications of physical frailty, social frailty, and cognitive dysfunction in hospitalized elderly patients with heart failure were unclear.

Does the coexistence of multiple frailty domains increase the risk of heart failure rehospitalization and all-cause death in hospitalized elderly patients with heart failure?

Population

1180 hospitalized heart failure patients aged ≥65 years

Comparison

1, 2, or 3 frailty domains vs 0 domains

Design

Prospective multicentre cohort study

Follow-up

1 year

Authors

YMYuya MatsueKKKentaro KamiyaHSHiroshi Saito

Discussion

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Overview

Multiple frailty domains may aid risk stratification in elderly HF inpatients; leaves open whether targeted interventions improve outcomes.

Study Design

Type

Cohort (n=1,180)

Multicenter

Yes

Structured PICO

Does the coexistence of multiple frailty domains increase the risk of heart failure rehospitalization and all-cause death in hospitalized elderly patients with heart failure?

P
Population
1,180 hospitalized patients with heart failure aged ≥65 years, median age 81 years, 57.4% male.
I
Intervention
Presence of 1, 2, or 3 frailty domains (physical frailty evaluated by Fried phenotype model, social frailty by Makizako's 5 items, and cognitive dysfunction by Mini-Cog)
C
Comparator
0 frailty domains
O
Outcome
Combined endpoint of heart failure rehospitalization and all-cause death within 1 yearcomposite

Main Result

Effect estimate: HR 2.04 (95% CI 1.28-3.24)

p-value: p=0.003

The coexistence of multiple frailty domains is highly prevalent in elderly hospitalized heart failure patients and provides additive prognostic value for predicting 1-year mortality and rehospitalization.

Cite This Study

Matsue et al. (2020) conducted a cohort in heart failure (n=1,180). Multiple frailty domains vs. 0 frailty domains was evaluated on combined endpoint of heart failure rehospitalization and all-cause death within 1 year (HR 2.04, 95% CI 1.28-3.24, p=0.003). Having 3 frailty domains versus 0 domains significantly increased the risk of 1-year heart failure rehospitalization or all-cause death (HR 2.04; 95% CI 1.28-3.24; P=0.003).

synapsesocial.com/papers/6a1719a287c007abbc0558b0https://doi.org/10.1002/ejhf.1926
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Mini-Cog Performance2014 · 134 citations
  2. 2Survival after the onset of congestive heart failure in Framingham Heart Study subjects.1993 · 1,873 citations
  3. 3Performance of the MAGGIC Heart Failure Risk Score and its Modification with the Addition of Discharge Natriuretic Peptides2018 · 127 citations
  4. 4The Global Health and Economic Burden of Hospitalizations for Heart Failure2014 · 2,072 citations
  5. 5Heart Failure Association of the European Society of Cardiology Position Paper on Frailty in Patients with Heart Failure2019 · 265 citations