Factores asociados a fragilidad en pacientes hospitalizados con insuficiencia cardiaca descompensada

Sánchez

Arch Peru Cardiol Cir Cardiovasc

et al. 2021

Objetivo. Determinar la prevalencia de fragilidad en adultos mayores con falla cardiaca y examinar la asociación entre la fragilidad y las características sociodemográficas y clínicas en pacientes del programa de falla cardiaca crónica del Hospital Nacional Guillermo Almenara Irigoyen en el periodo 2018-2020. Materiales y métodos. Estudio observacional, transversal y correlacional con enfoque cuantitativo en pacientes mayores de 60 años que tuvieron una valoración de fragilidad mediante la escala de Edmonton como no frágil (0-4), aparentemente vulnerable (5-6), levemente frágil (7-8), moderadamente frágil (9-10) y severamente frágil (11-17). La asociación de la fragilidad y las características de los pacientes se evaluó mediante la prueba de chi cuadrado de Pearson; se consideraron significativos los valores de p<0,05. y con un intervalo de confianza del 95%. Resultados. La prevalencia de fragilidad fue de 58,8%, la mayoría de los pacientes fueron del sexo masculino (71,8%) y el promedio de edad fue de 72,9 años. La edad y el número de comorbilidades fueron factores asociados a fragilidad estadísticamente significativos con p=0,004 y p<0,001 respectivamente. Conclusiones. La prevalencia de fragilidad fue alta en pacientes mayores de 60 años del programa de falla cardiaca crónica. Los pacientes de mayor edad y con mayor número de comorbilidades tuvieron mayor riesgo de fragilidad, lo cual destaca la necesidad de una evaluación integral y un cribado de la fragilidad a fin de diseñar programas de prevención secundaria de manera oportuna.

Section: Discussionunclassified

Fragilidad en adultos mayores con falla cardiaca crónica en un hospital de Lima

Sánchez

Arch Peru Cardiol Cir Cardiovasc

et al. 2021

“…In their 2018 study, Uchmanowicz et al [19] also proposed that frailty symptoms are highly prevalent among elderly HF patients, and the severity of frailty is directly associated with higher readmission rates. In the years 2016-2017, Vidán et al (2016) [20] and Díaz-Toro et al (2017) [21] independently reported frailty occurrence rates of 76% and 50.6% respectively in elderly HF patients, suggesting that the incidence of frailty in this population is relatively high. The relevant articles published between 2018 and 2021 also demonstrated that frailty was very common in patients with senile HF [22,23].…”

Section: Relationship Between Senile Hf and Frailtymentioning

confidence: 97%

Advances in the Application of Artificial Intelligence Technology in the Frailty State of Elderly Heart Failure Patients

Zhou,

Li,

et al. 2023

Preprint

With social ageing, the prevalence of heart failure (HF) rises. As an end-stage symptom of heart disease, HF usually shows poor clinical prognosis and even threatens patients’ lives. As a senile syndrome, frailty has significant impacts on the developmental outcomes of HF patients (mortality, readmission rate, and body function). Hence, frailty should be clinically identified and alleviated in time to improve the prognosis for patients. Patients and medical workers should pay more attention to frailty to lower the incidence of adverse events, improve the survival, and prolong survival time among HF patients. Besides, it is essential to perform early clinical diagnosis and treatment of HF. With the development of science, artificial intelligence (AI) shows great potential in heart disease. At present, AI is applied in the auxiliary diagnosis and treatment of HF, which brings about great reform in the prevention, diagnosis, and treatment of clinical diseases. Therefore, brief and comprehensive exploration and analysis were performed on the relationship between senile HF and frailty and the effects of frailty on the prognosis for patients to enable readers to further understand the effects of frailty on HF and to concern more on HF combined with frailty. What’s more, applying AI in the diagnosis and treatment of HF was investigated and its advantages and limitations were analyzed to provide basis for further enhancing performance of AI in HF and improve clinical diagnostic accuracy for HF patients and poor prognosis.

“…The guidelines report that frailty, regardless of age, is a multidimensional condition that predisposes patients with heart failure to stress factors and has a poor prognosis [ 76 ]. It was found that frailty was high in hospitalized patients with decompensated heart failure, and frailty was associated with age, quality of life, hospitalization, and polypharmacy in these patients [ 77 ]. Acute and chronic heart failure diagnosis and treatment guidelines emphasize that frailty should be considered as a part of the evaluation and in the treatment of heart failure patients [ 78 ].…”

Section: Predictive and Preventive Strategiesmentioning

confidence: 99%

Predictive Strategies to Reduce the Risk of Rehospitalization with a Focus on Frail Older Adults: A Narrative Review

Bag Soytas,

Levinoff,

Smith

et al. 2023

Epidemiologia

Frailty is a geriatric syndrome that has physical, cognitive, psychological, social, and environmental components and is characterized by a decrease in physiological reserves. Frailty is associated with several adverse health outcomes such as an increase in rehospitalization rates, falls, delirium, incontinence, dependency on daily living activities, morbidity, and mortality. Older adults may become frailer with each hospitalization; thus, it is beneficial to develop and implement preventive strategies. The present review aims to highlight the epidemiological importance of frailty in rehospitalization and to compile predictive strategies and related interventions to prevent hospitalizations. Firstly, it is important to identify pre-frail and frail older adults using an instrument with high validity and reliability, which can be a practically applicable screening tool. Comprehensive geriatric assessment-based care is an important strategy known to reduce morbidity, mortality, and rehospitalization in older adults and aims to meet the needs of frail patients with a multidisciplinary approach and intervention that includes physiological, psychological, and social domains. Moreover, effective multimorbidity management, physical activity, nutritional support, preventing cognitive frailty, avoiding polypharmacy and anticholinergic drug burden, immunization, social support, and reducing the caregiver burden are other recommended predictive strategies to prevent post-discharge rehospitalization in frail older adults.