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.
Frailty has been included in geriatric comprehensive assessment, which may not only be useful for evaluation of the functional status of elderly patients, but also contribute to the prognostic efficacy for patients with HFrEF.
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.
Frailty and pre-frailty were common in this population, with a prevalence of 53.6% and 36.9%. Moreover, compared to patients with pre-frailty, frail patients with HFrEF were more likely to be female, to have lower blood pressure, and to present with left ventricular thrombosis. Importantly, frail patients with HFrEF had a higher composite incidence of in-hospital adverse events. Additionally, compared with pre-frailty, frailty was associated with poor in-hospital outcomes in elderly patients with HFrEF.
Frailty may be associated with poor prognosis during hospitalization in elderly patients with HFrEF.
The results should be validated in multicenter prospective cohort studies. Future studies are needed to determine whether early rehabilitation targeting frailty can improve the clinical outcomes in elderly patients with HFrEF.