What is the clinical evidence from this study?

Study design: Cohort. Population: Heart Failure (n=8691). Intervention: Admission anemia severity vs. Non-anemia. Primary outcome: Frailty at discharge (Japanese Cardiovascular Health Study criteria ≥3) (OR 1.18, 95% CI 1.10-1.27, p=<0.001).

What does this research mean for the field?

Admission anemia severity is associated with frailty at discharge, hospitalization-associated disability, and 1-year mortality after discharge in patients hospitalized for heart failure. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To determine the relationship between admission anemia severity and frailty, hospitalization-associated disability, and 1-year mortality in heart failure patients.

July 20, 2026Circulation Reports0 citationsOpen Access

Association of Admission Anemia Severity With Frailty and Hospitalization-Associated Disability at Discharge and 1-Year Mortality After Discharge in Patients With Heart Failure　― A Multicenter Cohort Analysis of the J-Proof HF Registry ―

Q: What are the key findings of this study?

Higher admission anemia severity was independently associated with increased odds of frailty at discharge (OR 1.18 per 1-category increase), whereas associations with hospitalization-associated disability and 1-year mortality were attenuated after expanded adjustment.

Q: What does this research mean for the field?

Admission anemia severity is associated with frailty at discharge, hospitalization-associated disability, and 1-year mortality after discharge in patients hospitalized for heart failure. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

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

To determine the relationship between admission anemia severity and frailty, hospitalization-associated disability, and 1-year mortality in heart failure patients.

YHYusuke Hanafusa KIKentaro Iwata KKKentaro Kamiya

Key Result

Higher admission anemia severity was independently associated with increased odds of frailty at discharge (OR 1.18 per 1-category increase), whereas associations with hospitalization-associated disability and 1-year mortality were attenuated after expanded adjustment.

Key Points

To determine the relationship between admission anemia severity and frailty, hospitalization-associated disability, and 1-year mortality in heart failure patients.
Multicenter cohort analysis using the J-Proof HF Registry
Evaluation of anemia severity at hospital admission
Assessment of frailty, hospitalization-associated disability, and mortality outcomes.
Greater anemia severity correlates with increased frailty and hospitalization-associated disability at discharge.
1-year mortality is higher among patients with severe anemia upon admission.

Study Design

Type

Cohort (n=8,691)

Multicenter

Yes

Structured PICO

Does admission anemia severity predict frailty at discharge, hospitalization-associated disability, and 1-year mortality in older patients hospitalized for heart failure?

Population

8,691 older adults (aged ≥65 years) hospitalized for acute heart failure, followed for up to 1 year after discharge to assess functional outcomes and mortality.

Exposure

Admission anemia severity

Outcome

Frailty at discharge, hospitalization-associated disability (HAD), and 1-year mortality after discharge

Main Result

Odds Ratio: 1.18 (95% CI 1.1–1.27)

p-value: p=<0.001

Limitations

Observational design precludes causal inferences
Follow-up information based on postal questionnaires with potential selection bias due to incomplete follow-up
Pre-admission Barthel Index was assessed through interviews rather than direct measurements
Timing of blood sampling was not strictly standardized across participating institutions
Cognitive impairment was defined using different screening instruments across institutions
Lack of iron indices and information on the causes of anemia prevented stratification by anemia etiology

Abstract

Background: Anemia and functional decline are common in older patients hospitalized for heart failure. We examined whether anemia severity at admission was associated with frailty at discharge, hospitalization-associated disability (HAD), and 1-year mortality after discharge.

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Cite This Study

Hanafusa et al. (Fri,) conducted a cohort in Heart Failure (n=8,691). Admission anemia severity vs. Non-anemia was evaluated on Frailty at discharge (Japanese Cardiovascular Health Study criteria ≥3) (OR 1.18, 95% CI 1.10-1.27, p=<0.001). Higher admission anemia severity was independently associated with increased odds of frailty at discharge (OR 1.18 per 1-category increase), whereas associations with hospitalization-associated disability and 1-year mortality were attenuated after expanded adjustment.

synapsesocial.com/papers/6a5dba128bd453d3397ab56f https://doi.org/https://doi.org/10.1253/circrep.cr-26-0130