Frailty and Clinical Outcomes in Heart Failure: A Systematic Review and Meta-analysis

Zhang, Yunpeng; Yuan, Ming; Gong, Mengqi; Tse, Gary; Li, Guangping; Liu, Tong

doi:10.1016/j.jamda.2018.06.009

Cited by 84 publications

(72 citation statements)

References 44 publications

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“…The presence of frailty has a negative impact on the prognosis of patients with HF. Frailty accelerates the progression of HF and increases morbidity and mortality in these patients . Frailty contributes to a higher risk of mortality at 1 year, increased HF hospitalisations with longer bed days in hospital, and a decreased probability of surviving more than 10 years.…”

Section: Frailty In Heart Failurementioning

confidence: 99%

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Heart Failure Association of the European Society of Cardiology position paper on frailty in patients with heart failure

Vitale

Jankowska

Hill

et al. 2019

European J of Heart Fail

169

191

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Heart failure (HF) and frailty are two distinct yet commonly associated conditions. The interplay between the two conditions is complex, due to overlaps in underlying mechanisms, symptoms and prognosis. The assessment of frailty in patients with HF is crucial, as it is associated with both unfavourable outcomes and reduced access and tolerance to treatments. However, to date a consensus definition of frailty in patients with HF remains lacking and the need for a validated assessment score, for identifying those HF patients with frailty, is high and timely. This position paper proposes a new definition of frailty for use by healthcare professionals in the setting of HF and creates a foundation for the design of a tailored and validated score for this common condition.

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Section: Frailty In Heart Failurementioning

confidence: 99%

“…Frailty accelerates the progression of HF and increases morbidity and mortality in these patients. 24,[29][30][31] Frailty…”

Section: Prognosismentioning

confidence: 99%

Heart Failure Association of the European Society of Cardiology position paper on frailty in patients with heart failure

Vitale

Jankowska

Hill

et al. 2019

European J of Heart Fail

169

191

View full text Add to dashboard Cite

show abstract

“…the phenotype of frailty by Fried et al, FI, Canadian Study of Health and Aging Clinical Frailty Scale) is a significant predictor of all-cause mortality and hospital readmissions in people with heart failure. [1,33,52,78]…”

Section: Directions For Future Researchmentioning

confidence: 99%

Heart Failure and Problems with Frailty Syndrome: Why it is Time to Care About Frailty Syndrome in Heart Failure

et al. 2019

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Frailty syndrome (FS) is an independent predictor of mortality in cardiovascular disease and is found in 15–74% of patients with heart failure (HF). The syndrome has a complex, multidimensional aetiology and contributes to adverse outcomes. Proper FS diagnosis and treatment determine prognosis and support the evaluation of treatment outcomes. Routine FS assessment for HF patients should be included in daily clinical practice as an important prognostic factor within a holistic process of diagnosis and treatment. Multidisciplinary team members, particularly nurses, play an important role in FS assessment in hospital and primary care settings, and in the home care environment. Raising awareness of concurrent FS in patients with HF patients and promoting targeted interventions may contribute to a decreased risk of adverse events, and a better prognosis and quality of life.

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“…Frailty is known to be an important prognostic factor in patients with heart failure (HF) . Despite this, current risk‐adjustment models for patients with HF do not incorporate measures of frailty , likely because the identification of frailty generally requires face‐to‐face assessments and, for some definitions, even the use of specialized equipment to measure variables such as grip strength or walking speed .…”

Section: Introductionmentioning

confidence: 99%

The hospital frailty risk score in patients with heart failure is strongly associated with outcomes but less so with pharmacotherapy

et al. 2019

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Background Although frailty is known to be an important prognostic factor in heart failure (HF), HF risk‐adjustment models do not incorporate frailty measures and the interplay between frailty, age and pharmacotherapy is unclear. Objectives To explore the relationships between frailty, pharmacotherapy and outcomes in heart failure (HF). Methods Retrospective cohort study of all adults in Alberta, Canada hospitalized for the first time for HF between 2004 and 2016. Frailty was defined using the Hospital Frailty Risk Score (HFRS). Results In 26 626 patients (mean age 77.4 years), the 8887 (33.4%) defined as frail (HFRS ≥ 5) were older, had higher Charlson scores and more prior emergency department visits or hospitalizations. The HFRS and the Charlson Score were only weakly correlated (r = 0.35). Whilst more common in older patients (41.4% of patients 80 or older), frailty was present in 22.4% of patients younger than 65. Frail patients had longer lengths of stay and worse outcomes postdischarge, but adding the HFRS to age, sex and Charlson score did not improve prediction of events (c‐statistics 0.69 for 30‐day mortality after admission, and 0.54 for 30‐day readmission/ED visit/or death after discharge). Frail patients younger than 65 were significantly more likely than nonfrail patients 80 or older to be prescribed high‐dose evidence‐based HF therapies (27.1% vs. 22.2%, P = 0.003). Conclusion Although the HFRS reflects aspects of frailty that patient age and Charlson scores do not, the addition of the HFRS to standard risk prediction equations provides little additional information. Prescribing practices correlate more with patient age than frailty status.

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Frailty and Clinical Outcomes in Heart Failure: A Systematic Review and Meta-analysis

Cited by 84 publications

References 44 publications

Heart Failure Association of the European Society of Cardiology position paper on frailty in patients with heart failure

Heart Failure Association of the European Society of Cardiology position paper on frailty in patients with heart failure

Heart Failure and Problems with Frailty Syndrome: Why it is Time to Care About Frailty Syndrome in Heart Failure

The hospital frailty risk score in patients with heart failure is strongly associated with outcomes but less so with pharmacotherapy

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