Clinical Characteristics and Social Frailty of Super-Elderly Patients With Heart Failure　― The Kitakawachi Clinical Background and Outcome of Heart Failure Registry ―

Takabayashi, Kensuke; Ikuta, Akihiro; Okazaki, Yoshimasa; Ogami, M.; Iwatsu, Kotaro; Matsumura, K; Ikeda, Tsutomu; Ichinohe, Tahei; Morikami, Yasuhiro; Yamamoto, Takashi; Fujita, Ryoko; Takenaka, Kotoe; Takenaka, Hiroyuki; Haruna, Yoshisumi; Muranaka, Hiroyuki; Ozaki, Masaaki; Kitamura, Tetsuhisa; Kitaguchi, Shouji; Nohara, Ryuji

doi:10.1253/circj.cj-16-0914

Cited by 52 publications

(68 citation statements)

References 25 publications

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“…10) Moreover, the total hospital stay in the transfer group was 16 days, which is shorter than that in the study that evaluated the data within the ATTEND registry even though the patients in the transfer group of the current study were older than those in the ATTEND registry (84.0 years versus 73.0 years, respectively). 1) The findings from a previous study 11) showed that a longer period of hospitalization itself is a risk for impaired ADL; therefore, shortening the duration of hospital stay may be effective in preventing the risk of social frailty, particularly among elderly patients. The findings from the EVEREST study also showed that implementing a strict decongestion regimen before discharge reduced the frequency of adverse events.…”

Section: Discussionmentioning

confidence: 99%

Early Transfer of Patients with Acute Heart Failure from a Core Hospital to Collaborating Hospitals and Their Prognoses

et al. 2018

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Japan is facing problems associated with "heart failure (HF) pandemics" and bed shortages in core hospitals that can accommodate patients with acute HF. The prognosis is currently unknown for acute HF patients who were transferred from core hospitals to collaborating hospitals during the very early treatment phase and whose treatment strategies are in place.We enrolled 166 acute HF patients who were hospitalized between January 1, 2015, and December 31, 2015, and compared the conditions of transferred patients (n = 53, median duration before transfer = 6 days) and nontransferred patients (n = 113). The transferred and nontransferred patients had similar one-year mortality rates (24.5% versus 19.5%, log-rank P = 0.27) and composite one-year mortality and HF readmission rates (35.8% versus 31.0%, log-rank P = 0.32). Multivariate analysis determined that patient transfers were not associated with a higher composite endpoint (hazard ratio, 1.08; 95% confidence interval, 0.58-1.99, P = 0.82). Transferred patients with low composite congestion scores (CCSs) had significantly lower composite endpoints than those with high CCSs (23.5% versus 57.9%, log-rank P = 0.005).Acute HF patients who were transferred did not have inferior prognoses compared with nontransferred patients when the treatment strategies were correctly assumed by cardiologists. The implementation of early and strict decongestion strategies before transfer may be important for reducing cardiovascular events.

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Section: Discussionmentioning

confidence: 99%

Early Transfer of Patients with Acute Heart Failure from a Core Hospital to Collaborating Hospitals and Their Prognoses

et al. 2018

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“…In total, 13 hospitals participated in the registry. 10 Patients were diagnosed with HF based on the Framingham criteria, i.e., presence of at least two of the major criteria, or one major and two minor criteria. There were no exclusion criteria.…”

Section: Methodsmentioning

confidence: 99%

“…16 Definitions of comorbidities were described in our previous paper. 10 We divided the patients into two lifestyle groups: living alone or with a partner only and living with a child or other people. The main dietary manager was defined as the person who most frequently provided the patient with their meals, which can be the patients themselves, their partner, or others.…”

Section: Patient Data Definitionsmentioning

confidence: 99%

“…The Kitakawachi Clinical Background and Outcome of Heart Failure (KICKOFF) Registry was designed as a prospective, multicenter, community-based cohort of Japanese patients with AHF. 10 First, we used the database from the north of Kitakawachi and Yawata, which are typical satellite communities in Osaka and Kyoto, Japan. Then, we assessed the proportion of patients with AHF eligible for LTCI and compared them with communitydwelling elderly people with LTCI in the same region and the whole of Japan.…”

Section: Introductionmentioning

confidence: 99%

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Impact of home‐ and community‐based services in the long‐term care insurance system on outcomes of patients with acute heart failure: Insights from the Kitakawachi Clinical Background and Outcome of Heart Failure Registry

Takabayashi

Fujita

Iwatsu

et al. 2020

Geriatrics Gerontology Int

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In Japan, the long-term care insurance (LTCI) system is important for elderly people living at home; however, no clinical studies have revealed a relationship between home-or community-based services and outcomes in patients with acute heart failure (AHF). Methods: This was a prospective multicenter cohort study of patients with AHF enrolled between April 2015 and August 2017. Patients aged ≥65 years with LTCI were divided into those receiving home-and community-based services (service users) and without home and community-based services (service non-users). The endpoint was defined as a composite endpoint, which included all-cause mortality and hospitalization for heart failure after discharge. Subgroup analyses were performed for elderly patients (<85 years) or super-elderly patients (≥85 years). Results: The study participants were eligible for LTCI two times more than communitydwelling people were. At the 1-year follow-up period, the rate of the composite endpoint showed no significant difference between service users and service non-users among all patients or super-elderly patients. However, in elderly patients, the rate of the composite endpoint was significantly lower among service users than service non-users. The difference was independently maintained even after adjustments for differences in comorbidities or in social backgrounds (adjusted hazard ratio 0.62; 95% confidence interval 0.38-0.99, and adjusted hazard ratio 0.57; 95% confidence interval 0.35-0.90, respectively). Conclusions: In this study, adverse events following discharge of patients with AHF who used home-and community-based services were prevented only in elderly patients, not in super-elderly patients.

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“…Part B of the Tilburg Frailty Indicator (TFI) is the most commonly used instrument to assess social frailty. [9][10][11][12][13] This instrument contains a number of components that assess the domains of frailty, namely, physical, psychological, and social frailty. The social domain of frailty contains three items that include "living alone," "social relations," and "social support."…”

Section: Assessment Of Social Frailty Statusmentioning

confidence: 99%

Social Frailty Among Community-Dwelling Older Adults: Recommended Assessments and Implications

Makizako

Tsutsumimoto

Shimada

et al. 2018

Ann Geriatr Med Res

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Even though social factors that determine frailty in older people contribute to adverse health outcomes, there is little consensus in terms of the definition of social frailty. Therefore, in this article we reviewed literature on social frailty and attempted to define the term. Although we found that living alone, social participation, economic hardship, and other such factors are associated with a decline in activities of daily living and increased risk of disability, we have not reached an agreement on either the most effective methods of assessing social frailty or the most effective interventional approaches to address social frailty. Further investigations are needed to define social frailty and identify effective interventions to promote active aging by focusing on the social aspects in older adults with social frailty. It would be reasonable to think that this approach will also improve physical and cognitive frailty.

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Clinical Characteristics and Social Frailty of Super-Elderly Patients With Heart Failure　― The Kitakawachi Clinical Background and Outcome of Heart Failure Registry ―

Cited by 52 publications

References 25 publications

Early Transfer of Patients with Acute Heart Failure from a Core Hospital to Collaborating Hospitals and Their Prognoses

Early Transfer of Patients with Acute Heart Failure from a Core Hospital to Collaborating Hospitals and Their Prognoses

Impact of home‐ and community‐based services in the long‐term care insurance system on outcomes of patients with acute heart failure: Insights from the Kitakawachi Clinical Background and Outcome of Heart Failure Registry

Social Frailty Among Community-Dwelling Older Adults: Recommended Assessments and Implications

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Clinical Characteristics and Social Frailty of Super-Elderly Patients With Heart Failure ― The Kitakawachi Clinical Background and Outcome of Heart Failure Registry ―

Cited by 52 publications

References 25 publications

Early Transfer of Patients with Acute Heart Failure from a Core Hospital to Collaborating Hospitals and Their Prognoses

Early Transfer of Patients with Acute Heart Failure from a Core Hospital to Collaborating Hospitals and Their Prognoses

Impact of home‐ and community‐based services in the long‐term care insurance system on outcomes of patients with acute heart failure: Insights from the Kitakawachi Clinical Background and Outcome of Heart Failure Registry

Social Frailty Among Community-Dwelling Older Adults: Recommended Assessments and Implications

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Clinical Characteristics and Social Frailty of Super-Elderly Patients With Heart Failure　― The Kitakawachi Clinical Background and Outcome of Heart Failure Registry ―