Key result
Frailty was independently associated with an increased risk of 90-day unplanned readmission (HR 1.469; 95% CI 1.318-1.637; P<0.01) and death in patients with chronic heart failure.
Why the study?
Frailty is strongly associated with adverse health outcomes in older heart failure patients, but its effect on unplanned readmissions and death in CHF patients aged 18 years or older needed exploration.
Does frailty increase the risk of 90-day unplanned readmissions and death in patients with chronic heart failure?
Cohort (n=342)
Yes
Does frailty increase the risk of 90-day unplanned readmissions and death in patients with chronic heart failure?
Hazard Ratio: 1.469 (95% CI 1.318–1.637)
Absolute Event Rate: 73.1% vs 26.9%
p-value: p=< 0.01
Frailty is highly prevalent in chronic heart failure patients and serves as a strong independent predictor for 90-day unplanned readmission and mortality, highlighting the need for routine frailty assessment.
Supports routine frailty assessment in chronic HF; hypothesis-generating for targeted interventions.
Background: Frailty is strongly associated with adverse health outcomes in older heart failure patients. Aims: We aimed to explore the effect of frailty on unplanned readmissions and death in chronic heart failure (CHF) patients aged 18 years or older. Methods: 342 chronic heart failure patients aged 18 years or older from heart centers of two tertiary care hospitals, located in north-west of China, were enrolled between July and December 2020. Frailty was assessed by the Tilburg Frailty Indicator. Patients were followed for unplanned readmissions, all-cause mortality at 30, 60, and 90 days after discharge. Multivariate cox regression models were used to analyze the effect of frailty on 90-day unplanned readmission and death in patients with CHF. Results: Frailty prevalence was 54.7% among 342 CHF patients, with a mean age of 64.65 ± 11.90 years. Compared to non-frailty CHF patients, the frailty CHF patients were older and had higher systolic blood pressure, longer duration of heart failure, more severe cognitive function, and more comorbidities ( P <0.05). Patients in the frail group had a higher incidence of unplanned readmission (73.1% vs. 26.9%, χ2 = 18.87, P < 0.01) and death (100% vs. 0%, χ2 = 6.94, P < 0.01) than those in the non-frail group. Multivariate cox regression analysis showed that frailty was an independent risk factor for 90-day unplanned readmission (HR = 1.469, 95% CI 1.318-1.637, P < 0.01) and 90-day death (HR=2.270, 95% CI 1.091-4.726, P <0.01) in patients with CHF. Discussion: Evaluation of frailty among CHF patients, include frailty in the routine evaluation of admission seems necessary to provide personalized intervention to improving their prognosis. Conclusion: Frailty is an independent predictor of unplanned readmission and death 90-day after discharge in CHF patients aged 18 years or older.
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Chi et al. (2024) conducted a cohort in chronic heart failure (n=342). Frailty vs. Non-frailty was evaluated on 90-day unplanned readmission (HR 1.469, 95% CI 1.318-1.637, p=< 0.01). Frailty was independently associated with an increased risk of 90-day unplanned readmission (HR 1.469; 95% CI 1.318-1.637; P<0.01) and death in patients with chronic heart failure.
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