Prevalence and associated factors of frailty in hospitalized elderly patients with heart failure.

BACKGROUND

Frailty is frequently observed in elderly hospitalized patients with heart failure. Recognizing its prevalence and associated factors is essential for early identification and may help reduce socioeconomic burdens. This study aimed to assess the prevalence, clinical features, and correlates of frailty in this population.

METHODS

This single-center cross-sectional study enrolled consecutive hospitalized patients aged≥60 years with heart failure from January 2023 to December 2023. According to the Clinical Frailty Scale (CFS), patients were classified into three groups: non-frailty (CFS 1-4), mild-to-moderate frailty (CFS 5-6), and severe frailty (CFS 7). Clinical characteristics were compared across groups using comprehensive geriatric assessment data and auxiliary examination results. A multivariable partial proportional odds model (PPOM) was employed to identify factors associated with frailty severity.

RESULTS

A total of 298 elderly patients with heart failure were enrolled, including 149 males (50.0%). The age of the subjects ranged from 60 to 101 years, with a median of 83 years. Amongst them, 234 (78.5%) were identified as having frailty, of whom 192 (82.1%) presented with mild-to-moderate frailty. Statistically significant differences were observed among the three groups in age, weight, body mass index, comorbidity status, activities of daily living, instrumental activities of daily living, mini-nutritional assessment short-form, short physical performance battery, performance-oriented mobility assessment, dominant calf circumference, grip strength, B-type natriuretic peptide, left ventricular ejection fraction (all P < 0.05). No statistically significant differences were found among the three groups in sex, height, hypertension, diabetes, coronary artery disease, arrhythmia, malnutrition, electrocardiographic abnormality grade (including atrial fibrillation, high voltage, T-wave changes, and ST-segment changes), or echocardiographic abnormality grade (including left heart enlargement and pulmonary hypertension) (all P > 0.05). Multivariate PPOM analysis indicated that comorbidity status, mini-nutritional assessment short-form, short physical performance battery, and left ventricular ejection fraction were significant associated factors for frailty in elderly patients with heart failure (all P < 0.05).

CONCLUSIONS

Hospitalized patients with heart failure show a high prevalence of frailty. Comorbidities, poor nutritional status (lower MNA-SF score), impaired physical function (lower SPPB score), and reduced LVEF are important correlates of frailty severity in these patients.