Characteristics and Outcomes of Frail Patients Hospitalised withCardiovascular Diseases

Abstract

Objective: Frailty, a pre-disability state, is highly prevalent in older patients and negatively affects prognosis during or after hospitalisation. We examined the factors associated with a frailty index and this index’s prognostic significance in a patient cohort with cardiovascular disease.Materials and Methods: In this prospective study, patients aged ≥65 years were admitted to a cardiology department for acutely decompensated cardiovascular diseases. The identification of seniors at risk-hospitalised patients (ISAR-HP) score was measured at admission, and two threshold values (≥2 and ≥4) were considered to define high-risk patients. Other variables included physical examination, laboratory testing, electrocardiogram, echocardiography, final diagnosis, course of hospitalisation and one-year mortality.Results: We enrolled 166 patients with a mean age of 79.2±7.6 years, and 51.2% of them were males. The main final primary diagnoses were as follows: 38.1% had acute heart failure, 15.1% supra-ventricular arrhythmias, 6.1% cardiac syncope, 5.4% deep vein thrombosis/pulmonary embolism, 4.8% acute coronary syndromes and 4.8% acute hypertension. The ISAR-HP was measurable in 97% of the cohort and identified 70.5% and 32.5% of patients at high risk of further decline depending on the threshold value retained. Among the baseline characteristics and blood tests, advanced age, female gender, past or present heart failure, lower haemoglobin concentration, increased N-terminal pro-B-type natriuretic peptide concentration, increased troponin concentration and the need for oxygen support were associated with ISAR-HP ≥2 (p