Retrospective Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 26, 2021; 9(36): 11208-11219
Published online Dec 26, 2021. doi: 10.12998/wjcc.v9.i36.11208
Association of frailty with in-hospital outcomes in elderly patients with heart failure
Yun-Peng Kang, Li-Ying Chen, Jia-Jia Zhu, Wen-Xian Liu, Chang-Sheng Ma
Yun-Peng Kang, Li-Ying Chen, Jia-Jia Zhu, Wen-Xian Liu, Chang-Sheng Ma, Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Center for Cardiovascular Diseases, Beijing 100029, China
Author contributions: Kang YP contributed to the investigation, methodology, data curation, writing - review and editing; Chen LY contributed to conceptualization, data curation, formal analysis, investigation, methodology, project administration, resources, software, supervision, validation, visualization, writing - original draft; Zhu JJ contributed to investigation, methodology, resources, software, supervision; Liu WX and Ma CS contributed to conceptualization, data curation, formal analysis, investigation, methodology, project administration, resources, software, supervision, validation, visualization, writing - original draft, writing - review and editing.
Supported by Beijing Municipal Administration of Hospitals Incubating Program, No. PX2018026.
Institutional review board statement: The protocol for the study was approved by the Ethic Committee of Beijing Anzhen Hospital before the initiation of the study. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent statement: Due to the retrospective nature of this study, the requirement for informed consent was waived.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
Data sharing statement: The datasets generated and analyzed during the current study are available from the corresponding author on reasonable request.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Chang-Sheng Ma, MD, Chief Physician, Professor, Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Center for Cardiovascular Diseases, No. 2 Anzhen Road, Chaoyang District, Beijing 100029, China. chshma@vip.sina.com
Received: May 16, 2021
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
ARTICLE HIGHLIGHTS
Research background

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.

Research motivation

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.

Research objectives

To evaluate the predictive efficacy of frailty, compared with pre-frailty, for adverse events in these patients.

Research methods

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.

Research results

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.

Research conclusions

Frailty may be associated with poor prognosis during hospitalization in elderly patients with HFrEF.

Research perspectives

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.