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Frailty in elderly patients with acute heart failure increases readmission

Published:September 18, 2022DOI:https://doi.org/10.1016/j.hrtlng.2022.08.021

      Highlights

      • We examined the factors associated with readmission and number of readmissions.
      • Improvement of frailty is important to reduce the readmission rate.
      • Improvement of frailty is important to reduce the number of readmissions.

      Abstract

      Background

      The readmission rate of heart failure (HF) patients has not decreased during the past few years.

      Objectives

      The purpose of this study was to examine whether factors such as left ventricular ejection fraction (LVEF) and frailty are associated with readmission and number of readmissions in HF patients.

      Methods

      First, a propensity score matching method was used to adjust for confounding factors for readmission. Cox regression analysis was conducted to determine the factors that influenced readmission. Finally, multiple regression analysis was conducted to determine the factors that influenced the number of readmissions. The independent variables were basic and medical information, physical structure, physical functions, and activity for both Cox regression analysis and multiple regression analysis.

      Results

      After matching based on the propensity score, 18 out of 18 (100.0%) patients in the readmission group (age: 85.0 ± 6.9 years, female rate: 50.0%, body mass index: 21.7 ± 3.4 kg/m2) and 18 out of 51 (35.3%) patients in the nonreadmission group (age: 84.3 ± 8.6, female rate: 50.0%, body mass index: 21.8 ± 4.5 kg/m2) were eligible for analysis. Cox regression analysis (hazard ratios) showed that sex (0.16), geriatric nutritional risk index (1.02), and degree of frailty (11.44) were extracted as significant factors. Multiple regression analysis (standardized regression coefficients) showed that the estimated glomerular filtration rate (−0.40), LVEF (−0.32), and degree of frailty (0.29) were extracted as significant factors.

      Conclusion

      Our results suggest that frailty is important to reduce the readmission rate and number of readmissions of the acute HF patients.

      Keywords

      Abbreviations:

      heart failure (HF), left ventricular ejection fraction (LVEF), heart failure with reduced ejection fraction (HFrEF), heart failure with preserved ejection fraction (HFpEF), Hasegawa dementia rating scale-revised (HDS-R), area under the receiver operating characteristic (AUROC), body mass index (BMI), life space assessment (LSA), geriatric nutritional risk index (GNRI), brain natriuretic peptide (BNP), estimated glomerular filtration rate (eGFR), hemoglobin (Hb), skeletal muscle mass index (SMI), short physical performance battery (SPPB), hazard ratios (HRs)
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