Unit:
Faculty of MedicineLibrary of the School of Health Sciences
Dissertation committee:
Παρασκευαΐδης Ιωάννης, Ομότιμος Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Τουμανίδης Σάββας ,Ομότιμος Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Πάντος Κωνσταντίνος, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Αγγέλη Κωνσταντίνα, Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Σταματελόπουλος Κίμων, Αν. Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Μανιός Ευστάθιος, Αν. Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Μπριασούλης Αλέξανδρος, Επίκουρος Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Original Title:
Η ευθραυστότητα ως προγνωστικός δείκτης για μείζονα συμβάντα σε ασθενείς με καρδιακή ανεπάρκεια και κλάσμα εξωθήσεως αριστερής κοιλίας μεγαλύτερο ή ίσο 40%
Translated title:
Assessment of frailty and related outcomes in older patients with heart failure and LVEF>40%: a Cohort Study
Summary:
Background: Heart failure (HF) is a common cause of morbidity and mortality in older patients.
Frailty is prevalent and complicates the course of HF. We sought to investigate the impact of frailty
on HF outcomes.
Methods: Patients over 65 years old hospitalized with acute decompensated HF and mildly
reduced or preserved EF, between September, 2017 and September, 2019 were enrolled in the
study. Before hospital discharge at euvolemic state, patients underwent six-minute walk test
(6MWT) and frailty assessment using FRIED and modified SOF scores. Predictors of death,
readmissions and increase in diuretic dose were analyzed by multivariable logistic regression
models.
Results: We enrolled 193 consecutive patients (mean age 78.6±8.4 years, 29.5% males, 59.6%
with HF and preserved EF). All patients had at least one comorbidity (40.9% coronary artery
disease, 71% diabetes, 86% hypertension). The mean 6MWT distance was 316.2 meters.
According to FRIED score 4.7% were normal, 17.6% were categorized as pre-frail and 77.7% as
frail, while according to SOF index 9.8% were normal, 15% were categorized as pre-frail and 75.1%
as frail. Frail patients according to both indices had higher risk of 90-day readmissions, up-titration
of diuretics within 90-days (p<0.001 for both) and numerically but not significantly higher risk of
death. Frailty status was independently associated with higher risk of 90-day readmissions,
uptitration of diuretics and higher BNP at 90-days.
Conclusions: Frailty in older patients with HF is common and associated with worse prognosis.
Pre-discharge frailty assessment may aid in identification of patients at high-risk for short-
termcomplications.
Main subject category:
Health Sciences
Keywords:
Heart failure, Frailty, Readmissions, Comorbidities
Number of references:
153
