Published online Dec 26, 2021. doi: 10.12998/wjcc.v9.i36.11208
Peer-review started: May 16, 2021
First decision: June 15, 2021
Revised: June 28, 2021
Accepted: August 17, 2021
Article in press: August 17, 2021
Published online: December 26, 2021
Processing time: 220 Days and 23.5 Hours
Frailty is prevalent in elderly patients with cardiovascular diseases. However, the association between frailty and in-hospital outcomes for elderly patients with heart failure and reduced ejection (HFrEF) remains unknown.
To evaluate the predictive efficacy of frailty, compared with pre-frailty, for adverse events in these patients.
Elderly patients (≥ 60 years) with HFrEF were assessed. Frailty was evaluated with the Fried phenotype criteria, and physical performance was evaluated based on handgrip strength and the short physical performance battery (SPPB). The composite incidence of adverse events, including all-cause death, multiple organ failure, cardiac shock, and malignant arrhythmia, during hospitalization was recorded.
Overall, 252 elderly individuals with HFrEF [mean age: 69.4 ± 6.7 years, male: 169 (67.0%)] were included. One hundred and thirty-five (53.6%) patients were frail and 93 (36.9%) were pre-frail. Frail patients were older, more likely to be female, to have a lower blood pressure, and to present with left ventricular thrombosis (P all < 0.05). Frail patients with HFrEF had a higher incidence of in-hospital mortality (11.9% vs 4.3%, P = 0.048). Multivariate analyses showed that female gender (OR = 0.422), aging (OR = 1.090), poor cardiac functional class (OR = 2.167), frailty (OR = 2.379), and lower handgrip strength (OR = 1.106) were independent predictors of in-hospital adverse events (P all < 0.05).
Frailty may be associated with poor in-hospital outcomes for elderly patients with HFrEF. The influence of frailty on long-term prognosis in these patients deserves further investigation.
Core Tip: This retrospective study included 252 elderly individuals with heart failure and reduced ejection who showed a high prevalence of frailty (53.6%) and pre-frailty (36.9%). Female gender, aging, poor cardiac functional class, frailty, and lower handgrip strength were found to be independent predictors of in-hospital adverse events in these patients. Taken together, frailty is prevalent in elderly individuals with heart failure and reduced ejection, and frailty may be associated with poor in-hospital outcomes for these patients.