心臓血管薬理学: オープンアクセス

概要

Predictive values of frailty and malnutrition on 6-month all-course death and readmission in gerontal stage B heart failure inpatients

Pei-Pei Zheng

Background: Frailty increase the adverse outcome of clinical heart failure, however, the relation between frailty and stage B heart failure (SBHF) remain unknown.

Methods: Prospective cohort of SBHF inpatients aged 65 years or over who hospitalized between September 2018 and February 2019 and follow up for 6 months. Frailty was assessed by Fried frailty phenotype. Multivariable logistic regression and Cox proportional hazards regression were used to explore the independent risk and prognostic factors.

Results: Data for 443 participants were analyzed. Mean age was 76.1 years (SD=6.79), 165 (49.4%) were male and 109 (24.6%) were frailty. Age (OR 1.68, 95%CI: 1.028-1.110), polypharmacy (OR 1.782, 95%CI: 1.052-3.021), malnutrition (OR 4.083, 95%CI: 1.261-13.223) and cognition impairment (OR 2.386, 95%CI: 1.304-4.364) were independent risk factors of frailty. Frailty was 1.781 (95%CI 1.034-3.098, P=0.041) times more at risk of 6-months death or readmission independent of age, gender, LVEF and NT-proBNP. Malnutrition was an independent predictor of 6-month all-course death or readmission in frail gerontal SBHF inpatients (HR 3.852, 95%CI: 1.585-9.375, P=0.003).

Conclusion: Frailty is common in gerontal SBHF inpatients (GIs-SBHF) and older age, polypharmacy, malnutrition, cognition impairment can increase the risk of frailty. Frailty and nutrition status should be considered among GIs-SBHF to identify the individuals with high risk of death or readmission.