A simple effective method for frailty in Heart Failure with impact on clinical outcomes in north Indian population
Introduction and Objectives: Frailty has been studied extensively in elderly population as a predictor and prognostic marker for morbidity and mortality. Frailty is being increasingly recognised as a distinct pathophysiological condition which plays a major role in outcomes of various disease states including heart failure. Our aim was to study the prevalence of frailty in heart failure and see its prognostic significance in such patients. Methods: This was a prospective study conducted in an out-patient HF clinic. All consecutive patients with HF, > 25 years age, with LVEF < 40 % were included. All patients were asked a simple frailty questionnaire. Hand-dynamometer was used to assess handgrip strength in kilograms and were classified as frail, pre-frail or non-frail. The primary end point was cardiovascular mortality and hospitalization, and secondary end-point was composite of all cause mortality, hospitalization,device implantation and documented arrythmia. Results: 210 patients were studied for clinical outcomes.Mean age was 60.59+ 11.55 years with 15 % patients aged less than 50 years. Mean LVEF was 30.24+ 6.8%. Handgrip strength was poor in the frail vs non/pre-frail patients (p=0.001) with a strength >16.95 kg having sensitivity of 72% and specificity of 63% for the prediction of survival. Frailty was an independent predictor of mortality with higher mortality and re-hospitalization in frail population (p=0.001). Hazard for mortality or hospitalization was 4.7 fold in frail population. Conclusion: Frailty is associated with a significant morbidity andmortality in heart failure. A simple bedside hand-dynamometer may aid as a frailty screening tool in these patients and help in planning treatment strategies. Abbrevations: ACE-I/ARB-Angiotensin converting enzyme inhibitor, Angiotensin receptor blocker, BNP-Brain natriuretic peptide,BMI-Body mass index, IHD-Ischemic heart disease, TSH-Thyroid stimulating hormone
Singh, Gurbhej; Tandon, Rohit; Pandey, Neelesh C.; Bansal, Namita; Goyal, Abhishek; Singh, Bhupinder; Chhabra, Shibba Takkar; Aslam, Naved; Wander, Gurpreet Singh; and Mohan, Bishav
"A simple effective method for frailty in Heart Failure with impact on clinical outcomes in north Indian population,"
Journal of the Saudi Heart Association: Vol. 33
, Article 1.
Available at: https://doi.org/10.37616/2212-5043.1263
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