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Frailty and prognosis in heart failure. A prospective study with a quick and self-administered scale.
J Sanchez Vega1
GL Alonso Salinas1
S Del Prado Diaz1
JM Vieitez Florez1
E Gonzalez Ferrer1
1University Hospital Ramon y Cajal de Madrid, Cardiology - Madrid - Spain
Background Heart failure and its associated comorbidities are a delicate health condition that affects both life expectancy and the quality of life of patients. It is necessary to provide questionnaires or scales to stratify the short-term prognosis to address the need of medical attention or to know the death risks. Nowadays, we have scales like the Barcelona Bio-Heart Failure Risk Calculator (BioHF) or the Heart Failure Risk Calculator from MAGGIC investigation group, but its practical utility can be doubtful, due to the difficulties in completing these scales quickly in a consult setting. FRAIL scale has demonstrated a useful tool to detect frail patients at risk of suffering functional impairment, disability or death.
Material and methods We proceeded to recruit a consecutive sample from the Advanced Heart Failure consults. After all participants signed the informed consent, patients completed FRAIL scale a few minutes before their medical consult. A total of 42 patients were recruited. Following, we analyzed the number of hospital re-entry in relation to acute hearth failure and death, in a period of six months from the first contact, dividing the patients in two groups: frail patients (3 or more points in FRAIL scale) and non frail patients. There were no significant diferences in sex, age and comorbidities between both groups. We compared the results in these groups with the score of the BioHF scale without biomarkers.
Results Compared with non frail patients, the patients with 3 or more points in the scale presented higher rates of hospital ingress due to acute heart failure (33,3% vs 6,9%, p=0,003) and decease (16,7% vs 0%, p=0,024). The prognosis value of FRAIL scale was correlated with the score of the BioHF scale: in the one-year ingress, frail patients presented a bioHF score of 0,93% (vs 0,69 in non frail patients, p=0,044) and in death a BioHF of 32,5% (vs 17,1%, p=0,019).
Conclusions FRAIL scale has demonstrated in our study to be a useful, simple and fast acquiring tool to assess the risk of hospital re-entry and short-term mortality in patients with heart failure.
Results FollowingRisk Stratification After 6 Months
Acute heart failure hospital re-entry
BioHF one year hospital re-entry(%)
BioHF one year death(%)
The number of hospital re-entry and deaths are presented as absolute values and percentages.
Values of BioHF scale are presented as mean and standard deviation.
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