The impact of frailty according to Clinical Frailty Scale on clinical outcome in patients with heart failure
Abstract Aims There is currently no gold standard in evaluating frailty in patients with heart failure (HF), and the prognostic value of frailty according to the Canadian Study of Health and Aging Clinical Frailty Scale (CFS) on mortality in patients with HF is still unknown. Methods and results Amo...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2021-04-01
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| Series: | ESC Heart Failure |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/ehf2.13254 |
| _version_ | 1819120595178094592 |
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| author | Kenji Kanenawa Akihiro Isotani Kyohei Yamaji Miho Nakamura Yuichi Tanaka Kaoru Hirose‐Inui Shimpei Fujioka Shintaro Mori Mariko Yano Shinya Ito Takashi Morinaga Masato Fukunaga Makoto Hyodo Kenji Ando |
| author_facet | Kenji Kanenawa Akihiro Isotani Kyohei Yamaji Miho Nakamura Yuichi Tanaka Kaoru Hirose‐Inui Shimpei Fujioka Shintaro Mori Mariko Yano Shinya Ito Takashi Morinaga Masato Fukunaga Makoto Hyodo Kenji Ando |
| author_sort | Kenji Kanenawa |
| collection | DOAJ |
| description | Abstract Aims There is currently no gold standard in evaluating frailty in patients with heart failure (HF), and the prognostic value of frailty according to the Canadian Study of Health and Aging Clinical Frailty Scale (CFS) on mortality in patients with HF is still unknown. Methods and results Among consecutive 596 patients after their discharge from HF in Kokura Memorial Hospital (Kitakyushu, Japan) during 2015, their frailty at discharge was assessed according to CFS. Patients were classified into three groups: low (N = 232, 38.9%), intermediate (N = 230, 38.6%), and high (N = 134, 22.5%). The primary endpoint was defined as 2 year all‐cause death. The mean age was 76.6 ± 10.1 years, and 55.3% were men in entire cohort. There were significant differences in age, living environment, and dementia among low, intermediate, and high CFS groups. Left ventricular ejection fraction (LVEF) and co‐morbidities such as severe renal failure and severe anaemia tended to increase with frailty severity, while body mass index (BMI) and albumin level tended to decrease with frailty severity. Two year cumulative incidences of all‐cause death for the three groups were 12.8%, 25.4%, and 52.7% (P < 0.001), respectively. This significant difference in the risk for all‐cause death among the CFS groups was driven by the risk for cardiac (8.6%, 14.2%, and 31.0%, respectively, P < 0.001) and non‐cardiac death (4.6%, 13.0%, and 31.4%, respectively, P < 0.001). The multivariate analysis showed that high frailty was independently associated with all‐cause death (intermediate CFS group: adjusted hazard ratio, 1.43, 95% confidence interval, 0.86–2.36, P = 0.16; high CFS group: adjusted hazard ratio, 3.90, 95% confidence interval, 2.32–6.55, P < 0.001), and this result was consistent, irrespective of stratification based on age, sex, BMI, and LVEF without significant interaction. Conclusions The simple CFS tool was successful in predicting the risk for all‐cause death in patients with HF, and frailty according to CFS was independently associated with all‐cause death irrespective of stratification based on age, sex, BMI, and LVEF without significant interaction. The CFS is a valuable prognostic tool in clinical settings. |
| first_indexed | 2024-12-22T06:23:10Z |
| format | Article |
| id | doaj.art-72c2d4b1397a48d194d6bdfa0d176e9b |
| institution | Directory Open Access Journal |
| issn | 2055-5822 |
| language | English |
| last_indexed | 2024-12-22T06:23:10Z |
| publishDate | 2021-04-01 |
| publisher | Wiley |
| record_format | Article |
| series | ESC Heart Failure |
| spelling | doaj.art-72c2d4b1397a48d194d6bdfa0d176e9b2022-12-21T18:35:55ZengWileyESC Heart Failure2055-58222021-04-01821552156110.1002/ehf2.13254The impact of frailty according to Clinical Frailty Scale on clinical outcome in patients with heart failureKenji Kanenawa0Akihiro Isotani1Kyohei Yamaji2Miho Nakamura3Yuichi Tanaka4Kaoru Hirose‐Inui5Shimpei Fujioka6Shintaro Mori7Mariko Yano8Shinya Ito9Takashi Morinaga10Masato Fukunaga11Makoto Hyodo12Kenji Ando13Department of Cardiology Kokura Memorial Hospital 3‐2‐1 Asano, Kokurakita‐ku Kitakyushu 802‐8555 JapanDepartment of Cardiology Kokura Memorial Hospital 3‐2‐1 Asano, Kokurakita‐ku Kitakyushu 802‐8555 JapanDepartment of Cardiology Kokura Memorial Hospital 3‐2‐1 Asano, Kokurakita‐ku Kitakyushu 802‐8555 JapanDepartment of Cardiology Kokura Memorial Hospital 3‐2‐1 Asano, Kokurakita‐ku Kitakyushu 802‐8555 JapanDepartment of Cardiology Kokura Memorial Hospital 3‐2‐1 Asano, Kokurakita‐ku Kitakyushu 802‐8555 JapanDepartment of Cardiology Kokura Memorial Hospital 3‐2‐1 Asano, Kokurakita‐ku Kitakyushu 802‐8555 JapanDepartment of Cardiology Kokura Memorial Hospital 3‐2‐1 Asano, Kokurakita‐ku Kitakyushu 802‐8555 JapanDepartment of Cardiology Kokura Memorial Hospital 3‐2‐1 Asano, Kokurakita‐ku Kitakyushu 802‐8555 JapanDepartment of Cardiology Kokura Memorial Hospital 3‐2‐1 Asano, Kokurakita‐ku Kitakyushu 802‐8555 JapanDepartment of Cardiology Kokura Memorial Hospital 3‐2‐1 Asano, Kokurakita‐ku Kitakyushu 802‐8555 JapanDepartment of Cardiology Kokura Memorial Hospital 3‐2‐1 Asano, Kokurakita‐ku Kitakyushu 802‐8555 JapanDepartment of Cardiology Kokura Memorial Hospital 3‐2‐1 Asano, Kokurakita‐ku Kitakyushu 802‐8555 JapanDepartment of Cardiology Kokura Memorial Hospital 3‐2‐1 Asano, Kokurakita‐ku Kitakyushu 802‐8555 JapanDepartment of Cardiology Kokura Memorial Hospital 3‐2‐1 Asano, Kokurakita‐ku Kitakyushu 802‐8555 JapanAbstract Aims There is currently no gold standard in evaluating frailty in patients with heart failure (HF), and the prognostic value of frailty according to the Canadian Study of Health and Aging Clinical Frailty Scale (CFS) on mortality in patients with HF is still unknown. Methods and results Among consecutive 596 patients after their discharge from HF in Kokura Memorial Hospital (Kitakyushu, Japan) during 2015, their frailty at discharge was assessed according to CFS. Patients were classified into three groups: low (N = 232, 38.9%), intermediate (N = 230, 38.6%), and high (N = 134, 22.5%). The primary endpoint was defined as 2 year all‐cause death. The mean age was 76.6 ± 10.1 years, and 55.3% were men in entire cohort. There were significant differences in age, living environment, and dementia among low, intermediate, and high CFS groups. Left ventricular ejection fraction (LVEF) and co‐morbidities such as severe renal failure and severe anaemia tended to increase with frailty severity, while body mass index (BMI) and albumin level tended to decrease with frailty severity. Two year cumulative incidences of all‐cause death for the three groups were 12.8%, 25.4%, and 52.7% (P < 0.001), respectively. This significant difference in the risk for all‐cause death among the CFS groups was driven by the risk for cardiac (8.6%, 14.2%, and 31.0%, respectively, P < 0.001) and non‐cardiac death (4.6%, 13.0%, and 31.4%, respectively, P < 0.001). The multivariate analysis showed that high frailty was independently associated with all‐cause death (intermediate CFS group: adjusted hazard ratio, 1.43, 95% confidence interval, 0.86–2.36, P = 0.16; high CFS group: adjusted hazard ratio, 3.90, 95% confidence interval, 2.32–6.55, P < 0.001), and this result was consistent, irrespective of stratification based on age, sex, BMI, and LVEF without significant interaction. Conclusions The simple CFS tool was successful in predicting the risk for all‐cause death in patients with HF, and frailty according to CFS was independently associated with all‐cause death irrespective of stratification based on age, sex, BMI, and LVEF without significant interaction. The CFS is a valuable prognostic tool in clinical settings.https://doi.org/10.1002/ehf2.13254FrailtyClinical Frailty ScaleHeart failureDeath |
| spellingShingle | Kenji Kanenawa Akihiro Isotani Kyohei Yamaji Miho Nakamura Yuichi Tanaka Kaoru Hirose‐Inui Shimpei Fujioka Shintaro Mori Mariko Yano Shinya Ito Takashi Morinaga Masato Fukunaga Makoto Hyodo Kenji Ando The impact of frailty according to Clinical Frailty Scale on clinical outcome in patients with heart failure ESC Heart Failure Frailty Clinical Frailty Scale Heart failure Death |
| title | The impact of frailty according to Clinical Frailty Scale on clinical outcome in patients with heart failure |
| title_full | The impact of frailty according to Clinical Frailty Scale on clinical outcome in patients with heart failure |
| title_fullStr | The impact of frailty according to Clinical Frailty Scale on clinical outcome in patients with heart failure |
| title_full_unstemmed | The impact of frailty according to Clinical Frailty Scale on clinical outcome in patients with heart failure |
| title_short | The impact of frailty according to Clinical Frailty Scale on clinical outcome in patients with heart failure |
| title_sort | impact of frailty according to clinical frailty scale on clinical outcome in patients with heart failure |
| topic | Frailty Clinical Frailty Scale Heart failure Death |
| url | https://doi.org/10.1002/ehf2.13254 |
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