Frontiers in Cardiovascular Medicine (Dec 2020)

Prevalence and Prognostic Significance of Frailty in Gerontal Inpatients With Pre-clinical Heart Failure: A Subgroup Analysis of a Prospective Observational Cohort Study in China

  • Pei-Pei Zheng,
  • Pei-Pei Zheng,
  • Si-Min Yao,
  • Si-Min Yao,
  • Jing Shi,
  • Yu-Hao Wan,
  • Di Guo,
  • Ling-Ling Cui,
  • Ning Sun,
  • Hua Wang,
  • Hua Wang,
  • Jie-Fu Yang,
  • Jie-Fu Yang

DOI
https://doi.org/10.3389/fcvm.2020.607439
Journal volume & issue
Vol. 7

Abstract

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Objective: To evaluate the prognostic value of frailty in gerontal pre-clinical heart failure (stage B heart failure, SBHF) inpatients.Background: The association between frailty and SBHF remains unknown.Methods: We conducted a subgroup analysis of a prospective observational cohort study on frailty. The previous study recruited 1,000 elderly inpatients who were consecutively admitted to a tertiary referral hospital in Beijing, China, from September 2018 to February 2019. The outcomes were all-cause death or readmission at 1-year follow-up. SBHF was diagnosed for asymptomatic cardiac structural or functional abnormalities. Frailty was assessed using the Comprehensive Geriatric Assessment-Frailty Index (CGA-FI).Results: Overall, 531 inpatients aged ≥65 years were deemed to have SBHF and followed up for 1 year. Of them, 34.5% exhibited frailty. During the follow-up period, all-cause death or readmission occurred in 157 (29.5%) participants. Of these participants, 36.6% (67/183) and 25.9% (90/348) belonged to the frail and non-frail groups, respectively (χ2 = 6.655, P = 0.010). Frailty, defined by the CGA-FI, rather than Fried frailty phenotype, could independently predict 1-year all-cause death or readmission (hazard ratio, 1.56; 95% confidence interval, 1.03–2.35; P = 0.034) and was more suitable for predicting all-cause death or readmission than N-terminal pro-B-type natriuretic peptide in female SBHF inpatients aged 80 years or over(AUCCGA−FI vs. AUCNT−proBNP 0.654 vs. 0.575, P = 0.017).Conclusions: Frailty is highly prevalent even among SBHF inpatients aged ≥65 years. The CGA-FI can independently predict 1-year all-cause death or readmission, rather than Fried frailty phenotype. Frailty in gerontal SBHF inpatients deserves more attention.Clinical Trial registration: ChiCTR1800017204; date of registration: 07/18/2018.

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