Frailty is associated with 90-day unplanned readmissions and death in patients with heart failure: A longitudinal study in China

Chi, Junting; Chen, Fei; Zhang, Jing; He, Bin; Tao, Hongxia; Ruan, Haihui; Jin, Lei; Wang, Yanhong

doi:10.1016/j.hrtlng.2022.01.007

Cited by 12 publications

(4 citation statements)

References 46 publications

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“…All studies were longitudinal studies, and the adverse outcomes of frailty were followed for 90 days to 7 years. The reported adverse outcomes were increased hospital readmission, increased mortality, increased physical disability, increased healthcare utilization, decreased quality of life, increased falls and inappropriate responses to treatments (Andreasen et al, 2018; Chi et al, 2022; Gobbens et al, 2012; Gobbens et al, 2014; Gobbens et al, 2020; Gobbens et al, 2021; Gobbens & Andreasen, 2020; Gobbens & van Assen, 2012, 2014; Kluszczyńska & Młynarska, 2021; Mlynarska et al, 2018a, 2018b; Mlynarska et al, 2019; Mlynarska et al, 2021; Mulasso et al, 2017; Santiago et al, 2018; Torres‐Perez et al, 2021; van der Vorst et al, 2018).…”

Section: Resultsmentioning

confidence: 99%

Use of the Tilburg frailty indicator in longitudinal studies with older adults: A scoping review

Kim

Park

et al. 2023

Journal of Advanced Nursing

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Aim To understand how researchers applied the Tilburg Frailty Indicator (TFI) to older adults. The use of the TFI was examined based on the Integral Conceptual Model of Frailty (ICMF). Design A scoping review. Data Sources A database search was conducted without a time limit in PubMed, CINAHL, Embase and the Cochrane library. A hand search was also conducted. Review Methods Research questions were developed based on the population‐concept‐context framework suggested by the Joanna Briggs Institute (2017). Studies were included if topics were related to the use of the TFI or ICMF and designs were longitudinal studies. Results A total of 37 studies met the inclusion criteria. Studies were reviewed according to the tested pathways of the ICMF: determinants of frailty or adverse outcomes, adverse outcomes of frailty and comparison of predictive power between frailty measures. Conclusion The TFI is a useful tool to screen for frailty and predict health outcomes in older adults. Among the pathways of the ICMF, relationships between social factors and frailty were reported in several studies. Despite this relationship, social factors were considered as items to assess the social domain of frailty rather than determinants of frailty. The predictive power of the TFI was not superior to other frailty measures, but it had a high sensitivity. Impact This study demonstrates the usability of the TFI in older adults living in various conditions. Further studies are required to identify more effective ways to screen frailty using the TFI. Patient or Public Contribution No patient or public involvement in this study.

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Section: Resultsmentioning

confidence: 99%

Use of the Tilburg frailty indicator in longitudinal studies with older adults: A scoping review

Kim

Park

et al. 2023

Journal of Advanced Nursing

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“…The prevalence of this condition among community‐dwelling older individuals is significant, ranging from 8% to 16% 11 . Frailty is associated with higher morbidity and mortality in patients suffering from cardiovascular disease 12,13 . It has been proposed that recognizing frailty can aid clinicians in determining procedure risks, evaluating prognosis, and guiding management 14 …”

Section: Introductionmentioning

confidence: 99%

“…11 Frailty is associated with higher morbidity and mortality in patients suffering from cardiovascular disease. 12,13 It has been proposed that recognizing frailty can aid clinicians in determining procedure risks, evaluating prognosis, and guiding management. 14 Frailty syndrome in older individuals has received a lot of attention lately.…”

Section: Introductionmentioning

confidence: 99%

Frailty syndrome and associated factors among patients with hypertension: A cross‐sectional study in Kumasi, Ghana

Sakyi,

Tawiah,

Senu

et al. 2023

Health Science Reports

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Background and AimFrailty is a condition marked by accumulation of biological deficits and dysfunctions that come with aging and it is correlated with high morbidity and mortality in patients with cardiovascular diseases, particularly hypertension. Hypertension continues to be a leading cause of cardiovascular diseases and premature death globally. However, there is dearth of literature in sub‐Saharan Africa on frailty syndrome among hypertensives on medication. This study evaluated frailty syndrome and its associated factors among Ghanaian hypertensives.MethodsThis cross‐sectional study recruited 303 patients with hypertension from the University Hospital, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana. Data on sociodemographic, lifestyle and clinical factors were collected using a well‐structured questionnaire. Medication adherence was measured using Adherence in Chronic Disease Scale, and frailty was assessed by Tilburg Frailty Indicator. Statistical analyses were performed using SPSS Version 26.0 and GraphPad prism 8.0. p‐value of < 0.05 and 95% confidence interval (CI) were considered statistically significant.ResultsThe prevalence of frailty was 59.7%. The proportion of high, medium and low medication adherence was 23.4%, 64.4% and 12.2%, respectively. Being ≥ 70years (adjusted odds ratio [aOR]: 8.33, 95% CI [3.72–18.67], p < 0.0001), unmarried (aOR: 2.59, 95% CI [1.37–4.89], p = 0.0030), having confirmed hypertension complications (aOR: 3.21, 95% CI [1.36–7.53], p = 0.0080), medium (aOR: 1.99, 95% CI [1.05–3.82], p = 0.0360) and low antihypertensive drug adherence (aOR: 27.69, 95% CI [7.05–108.69], p < 0.0001) were independent predictors of increased odds of developing frailty syndrome.ConclusionApproximately 6 out of 10 Ghanaian adult patients with hypertension experience frailty syndrome. Hypertension complications, older age, being unmarried, and low antihypertensive drug adherence increased the chances of developing frailty syndrome. These should be considered in intervention programmes to prevent frailty among patients with hypertension.

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“…22 In addition, frailty in HF patients is also shown to be a strong predictor of the need for hospitalisation and an independent risk factor for increased hospital LOS, unplanned readmission and all-cause mortality. [23][24][25][26] Hence, we postulate that HF patients with higher scores on HFRS will have poorer health outcomes and higher healthcare utilisation in the local context, emphasising the importance of assessing for frailty status early among admission of HF patients to reduce adverse outcomes. 27 The primary outcome was to compare and validate the HFRS in predicting outcomes and hospitalisation usage in patients hospitalised for HF.…”

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confidence: 99%

Validation of Hospital Frailty Risk Score in Heart Failure

Teo,

Oh,

Huang

et al. 2024

J Asian Pac Soc Cardiol

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Background: Frailty is prevalent in older people and results from age-related decline in physiological function and reserve. The objective of this study was to validate the Hospital Frailty Risk Score (HFRS) in predicting outcomes and hospitalisation usage in older hospitalised heart failure (HF) patients. Methods: This study was a retrospective review of electronic medical records. Patients aged ≥65 years admitted with HF to a Singapore tertiary hospital between 1 January 2021 and 30 April 2021 were included. Patients were identified as HF patients in the value-driven care pathway and using ICD codes for HF. They were categorised into low risk (<5), intermediate risk (5–15) and high risk (>15) of frailty using the HFRS. Results: A total of 208 older patients with HF were included (mean age 79.4 years; 50.5% males). Using the HFRS, 35.1% were deemed at low risk, 46.2% at intermediate risk and 18.8% at high risk of frailty. Those at high risk of frailty were older than those at low risk (mean age 84.8 versus 76.5 years, respectively; p<0.001). Women had a higher risk of frailty than men. Univariate analyses showed longer length of stay (LOS) and higher 30-, 90- and 365-day mortality in those at high frailty risk. In multivariate analyses, HFRS was associated with long LOS, 90-day and 1-year mortality. Dementia, acute MI and renal disease were more common in high-risk patients. Comparing HFRS with the Charlson Comorbidity Index (CCI), HFRS was a better predictor of long LOS, mortality at 30, 90, 1 year and 30-day readmission than CCI. HFRS alone was a better predictor than combining the HFRS and CCI. Conclusion: Older patients with higher HFRS have increased healthcare utilisation, including longer LOS and higher mortality.

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Frailty is associated with 90-day unplanned readmissions and death in patients with heart failure: A longitudinal study in China

Cited by 12 publications

References 46 publications

Use of the Tilburg frailty indicator in longitudinal studies with older adults: A scoping review

Use of the Tilburg frailty indicator in longitudinal studies with older adults: A scoping review

Frailty syndrome and associated factors among patients with hypertension: A cross‐sectional study in Kumasi, Ghana

Validation of Hospital Frailty Risk Score in Heart Failure

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