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Frailty is associated with 90-day unplanned readmissions and death in patients with chronic heart failure: A longitudinal study in Northwest China
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  • Junting Chi,
  • Fei Chen,
  • Jing Zhang,
  • Xiaodan Niu,
  • Hongxia Tao,
  • Haihui Ruan,
  • Yanhong Wang
Junting Chi
First People's Hospital of Yunnan
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Fei Chen
Lanzhou University
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Jing Zhang
Lanzhou University
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Xiaodan Niu
Lanzhou University
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Hongxia Tao
Lanzhou University
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Haihui Ruan
Lanzhou University
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Yanhong Wang
Lanzhou University

Corresponding Author:[email protected]

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Abstract

Background: Frailty is strongly associated with adverse health outcomes in older heart failure patients. Aims: We aimed to explore the effect of frailty on unplanned readmissions and death in chronic heart failure (CHF) patients aged 18 years or older. Methods: 342 chronic heart failure patients aged 18 years or older from heart centers of two tertiary care hospitals, located in north-west of China, were enrolled between July and December 2020. Frailty was assessed by the Tilburg Frailty Indicator. Patients were followed for unplanned readmissions, all-cause mortality at 30, 60, and 90 days after discharge. Multivariate cox regression models were used to analyze the effect of frailty on 90-day unplanned readmission and death in patients with CHF. Results: Frailty prevalence was 54.7% among 342 CHF patients, with a mean age of 64.65 ± 11.90 years. Compared to non-frailty CHF patients, the frailty CHF patients were older and had higher systolic blood pressure, longer duration of heart failure, more severe cognitive function, and more comorbidities ( P<0.05). Patients in the frail group had a higher incidence of unplanned readmission (73.1% vs. 26.9%, χ2 = 18.87, P < 0.01) and death (100% vs. 0%, χ2 = 6.94, P < 0.01) than those in the non-frail group. Multivariate cox regression analysis showed that frailty was an independent risk factor for 90-day unplanned readmission (HR = 1.469, 95% CI 1.318-1.637, P < 0.01) and 90-day death (HR=2.270, 95% CI 1.091-4.726, P<0.01) in patients with CHF. Discussion: Evaluation of frailty among CHF patients, include frailty in the routine evaluation of admission seems necessary to provide personalized intervention to improving their prognosis. Conclusion: Frailty is an independent predictor of unplanned readmission and death 90-day after discharge in CHF patients aged 18 years or older.