AUTHOR=Zheng Pei-Pei , Yao Si-Min , Shi Jing , Wan Yu-Hao , Guo Di , Cui Ling-Ling , Sun Ning , Wang Hua , Yang Jie-Fu 

TITLE=Prevalence and Prognostic Significance of Frailty in Gerontal Inpatients With Pre-clinical Heart Failure: A Subgroup Analysis of a Prospective Observational Cohort Study in China

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=7

YEAR=2020

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2020.607439

DOI=10.3389/fcvm.2020.607439

ISSN=2297-055X

ABSTRACT=<p><bold>Objective:</bold> To evaluate the prognostic value of frailty in gerontal pre-clinical heart failure (stage B heart failure, SBHF) inpatients.</p><p><bold>Background:</bold> The association between frailty and SBHF remains unknown.</p><p><bold>Methods:</bold> We conducted a subgroup analysis of a prospective observational cohort study on frailty. The previous study recruited 1,000 elderly inpatients who were consecutively admitted to a tertiary referral hospital in Beijing, China, from September 2018 to February 2019. The outcomes were all-cause death or readmission at 1-year follow-up. SBHF was diagnosed for asymptomatic cardiac structural or functional abnormalities. Frailty was assessed using the Comprehensive Geriatric Assessment-Frailty Index (CGA-FI).</p><p><bold>Results:</bold> Overall, 531 inpatients aged ≥65 years were deemed to have SBHF and followed up for 1 year. Of them, 34.5% exhibited frailty. During the follow-up period, all-cause death or readmission occurred in 157 (29.5%) participants. Of these participants, 36.6% (67/183) and 25.9% (90/348) belonged to the frail and non-frail groups, respectively (χ<sup>2</sup> = 6.655, <italic>P</italic> = 0.010). Frailty, defined by the CGA-FI, rather than Fried frailty phenotype, could independently predict 1-year all-cause death or readmission (hazard ratio, 1.56; 95% confidence interval, 1.03–2.35; <italic>P</italic> = 0.034) and was more suitable for predicting all-cause death or readmission than N-terminal pro-B-type natriuretic peptide in female SBHF inpatients aged 80 years or over(AUC<sub>CGA−FI</sub> vs. AUC<sub>NT−proBNP</sub> 0.654 vs. 0.575, <italic>P</italic> = 0.017).</p><p><bold>Conclusions:</bold> Frailty is highly prevalent even among SBHF inpatients aged ≥65 years. The CGA-FI can independently predict 1-year all-cause death or readmission, rather than Fried frailty phenotype. Frailty in gerontal SBHF inpatients deserves more attention.</p><p><bold>Clinical Trial registration:</bold> ChiCTR1800017204; date of registration: 07/18/2018.</p>