医学
心力衰竭
内科学
混淆
回廊的
共病
射血分数
比例危险模型
前瞻性队列研究
多元分析
查尔森共病指数
心脏病学
作者
César Jiménez-Méndez,Pablo Díez‐Villanueva,Clara Bonanad,Carolina Ortiz-Cortés,Eduardo Barge‐Caballero,Josebe Goirigolzarri,Alberto Esteban‐Fernández,Ángel Pérez-Rivera,Marta Cobo,Javier López,Áncor Sanz-García,Carmen Guerrero,Héctor García Pardo,Carolina Robles,Diego Iglesias,José Manuel García Pinilla,Luis López Rodríguez,Françesc Formiga,Francisco Javier Martín‐Sánchez,María Teresa Vidán,Albert Ariza,Manuel Martínez‐Sellés,Fernándo Alfonso
标识
DOI:10.1016/j.rec.2022.04.016
摘要
Heart failure (HF) is prevalent in advanced ages. Our objective was to assess the impact of frailty on 1-year mortality in older patients with ambulatory HF.Our data come from the FRAGIC study (Spanish acronym for "Study of the impact of frailty and other geriatric syndromes on the clinical management and prognosis of elderly outpatients with heart failure"), a multicenter prospective registry conducted in 16 Spanish hospitals including outpatients ≥ 75 years with HF followed up by cardiology services in Spain.We included 499 patients with a mean age of 81.4±4.3 years, of whom 193 (38%) were women. A total of 268 (54%) had left ventricular ejection fraction <40%, and 84.6% was in NYHA II functional class. The FRAIL scale identified 244 (49%) pre-frail and 111 (22%) frail patients. Frail patients were significantly older, were more frequently female (both, P <.001), and had higher comorbidity according to the Charlson index (P=.017) and a higher prevalence of geriatric syndromes (P <.001). During a median follow-up of 371 [361-387] days, 58 patients (11.6%) died. On multivariate analysis (Cox regression model), frailty detected with the FRAIL scale was marginally associated with mortality (HR=2.35; 95%CI, 0.96-5.71; P=.059), while frailty identified by the visual mobility scale was an independent predictor of mortality (HR=2.26; 95%CI, 1.16-4.38; P=.015); this association was maintained after adjustment for confounding variables (HR=2.13; 95%CI, 1.08-4.20; P=.02).In elderly outpatients with HF, frailty is independently associated with mortality at 1 year of follow-up. It is essential to identify frailty as part of the comprehensive approach to elderly patients with HF.
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