Research Article: Frailty syndrome and rehospitalizations in elderly heart failure patients

Date Published: August 28, 2017

Publisher: Springer International Publishing

Author(s): Izabella Uchmanowicz, Maria Kuśnierz, Marta Wleklik, Beata Jankowska-Polańska, Joanna Jaroch, Krystyna Łoboz-Grudzień.

http://doi.org/10.1007/s40520-017-0824-6

Abstract

Heart failure (HF) patients with frailty syndrome (FS) are at higher risk of falling, decreased mobility, ability to perform the basic activities of daily living, frequent hospitalizations, and death.

The purpose of this study was to evaluate the correlations between FS and hospital readmissions, and to assess which factors are associated with rehospitalizations.

The study included 330 patients with a mean age of 72.1 ± 7.9 years, diagnosed with HF. Frailty was measured using the Polish version of the Tilburg Frailty Indicator (TFI). Demographic, sociodemographic, and clinical data, such as the New York Heart Association (NYHA) functional class, ejection fraction (EF), number of rehospitalizations, and the medications taken, were obtained.

Positive correlation was observed between the number of hospitalizations and FS. In the single-factor correlation analysis, treatment with diuretics, a higher NYHA class, and a lower left ventricular EF were predictors of a higher number of hospitalizations. Additionally, the physical and psychological components of the TFI, as well as the total TFI score, predisposed HF patients to more frequent hospitalizations.

It seems that a deterioration of functional capabilities and an increase in symptom severity naturally lead to increased hospitalization frequency in HF. In the own study, regression analysis indicates that high NYHA classes and TFI social component scores are significant predictors of the number of hospitalizations in the studied group.

FS is highly prevalent among elderly HF patients. Higher frailty levels in elderly patients are a determinant of more frequent rehospitalizations in HF.

Partial Text

Heart failure (HF) is the most common cause of hospitalization for patients older than 65. Despite developments in cardiovascular treatment, the high hospitalization rate has not changed for the last 20 years, and is currently one of the most significant challenges for health care systems worldwide [1]. Epidemiological data show that following a first hospitalization due to HF, 25% of patients are rehospitalized within 30 days, and 50% are rehospitalized within 6 months of the first hospitalization [2]. Within 5 years of diagnosis, 43% of HF patients are hospitalized five or more times [3]. HF is an increasingly serious epidemiological and clinical issue—the numbers of patients with HF are growing, due to factors including longer lifespans and higher survival rates of patients with acute coronary syndrome.

Considering the increasing age of HF patients, a special approach to their treatment is required, with more attention paid to geriatric conditions, e.g., FS. The purpose of this study was to evaluate the correlations between FS and hospital readmissions, and to assess which factors are associated with rehospitalizations.

HF is the most common cause of hospitalization for patients older than 65. Despite the developments in cardiovascular treatment, the high hospitalization rate has not changed for the last 20 years. The purpose of this study was to evaluate the impact of FS and hospital readmissions, and to assess variables associated with rehospitalizations.

Frailty is highly prevalent among elderly HF patients. Higher frailty levels in elderly patients are a determinant of frequent rehospitalizations in HF. For elderly patients with higher scores in the social TFI component, which denotes limited social support, the risk of rehospitalization is higher. Rehospitalization frequency is also significantly affected by a high NYHA class.

 

Source:

http://doi.org/10.1007/s40520-017-0824-6

 

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