The Effect of Frailty on 30‐day Mortality Risk in Older Patients With Acute Heart Failure Attended in the Emergency Department

Abstract

The presence of frailty is an independent risk factor of 30-day mortality in nonsevere dependent older patients attended with AHF in EDs.

Prognostic Value of Frailty for Older Patients with Heart Failure: A Systematic Review and Meta-Analysis of Prospective Studies

“…Table 1 summarizes the characteristics of the ten studies included in the systematic review. Four studies were conducted in Italy [ 20 , 22 , 26 , 28 ], three in the USA [ 19 , 25 , 27 ], and three in Spain [ 21 , 23 , 24 ]. In total, the studies included 3033 elderly patients with HF.…”

“…Eight studies were classified as “Physical Frailty” as they primarily used physical frailty assessment tools such as the Fried Frailty Phenotype (FP) measurement [ 19 , 21 , 23 , 24 , 27 ], portions of the five FP indicators (e.g., gait speed or handgrip strength)[ 25 , 28 ], or the Short Physical Performance Battery (SPPB) [ 26 ]. Two studies were classified as “Multidimensional Frailty” as they used a multidimensional frailty measurement tool: Frailty Staging System (FSS) [ 20 , 22 ], which evaluated multiple domains of elderly functioning.…”

“…The quality assessment of the included studies is described in Table 2 . For quality assessments, four studies were considered as having mild cohort selection bias as they were designed as multicenter studies [ 21 , 23 , 26 , 28 ]. One study was regarded as having high outcome bias, as it did not describe the outcome of the loss or evaluation methods of the endpoints [ 22 ].…”

The association of clinical frailty with outcomes of patients reviewed by rapid response teams: an international prospective observational cohort study

“…They used a clinical frailty score in order to assist clinicians in the planning and delivery of perioperative care for frail patients, with subsequent reductions in mortality. In patients with acute hospital admissions due to heart failure, a retrospective cohort study found the incidence of frailty to be 36% and independently associated with mortality at 30 days [ 16 ]. These data are consistent with our findings, however, our cohort captured patients from both medical and surgical specialities, with a preponderance of higher frailty scores in elderly patients admitted under medical specialities.…”

Acute Heart Failure in the Emergency Department: Just a One Night Stand?

“…The prognostic importance of one of these overarching AHF comorbidities, frailty in the elderly, was examined by Martin‐Sanchez and colleagues . Frailty has been defined as a “clinically recognizable state of increased vulnerability resulting from aging‐associated decline in reserve and function across multiple physiologic systems such that the ability to cope with an everyday or acute stressor is compromised.” Objectively, the definition put forth by Fried et al.…”