A Simple Risk Score Based on Routine Clinical Parameters Can Predict Frailty in Hospitalized Heart Failure Patients

Kałużna‐Oleksy, Marta; Kukfisz, Agata; Migaj, Jacek; Dudek, Magdalena; Krysztofiak, Helena; Sawczak, Filip; Szczechla, Magdalena; Przytarska, K; Straburzyńska‐Migaj, Ewa; Wleklik, Marta; Uchmanowicz, Izabella

doi:10.3390/jcm10245963

Cited by 8 publications

(6 citation statements)

References 52 publications

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“…In a study comparing community-dwelling adults stratified by their frailty, LDL-C was lower in the frail group, both when including and excluding patients with diabetes or CVD [26]. Recently, low total cholesterol levels have predicted long-term mortality in primary care patients [13], and frailty in heart failure patients [12]. Similarly, low LDL-C was associated with worse prognoses in patients with advanced kidney disease and coronary artery disease [11] and reported to be decreased in patients with COPD [10].…”

Section: Discussionmentioning

confidence: 99%

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Elevated low‐density lipoprotein cholesterol: An inverse marker of morbidity and mortality in patients with myocardial infarction

et al. 2023

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BackgroundThe incidence of atherosclerotic cardiovascular disease increases with levels of low‐density lipoprotein cholesterol (LDL‐C). Yet, a paradox may exist where lower LDL‐C levels at myocardial infarction (MI) are associated with poorer prognoses.ObjectiveTo assess the association between LDL‐C levels at MI with risk factor burden and cause‐specific outcomes.MethodsStatin‐naive patients hospitalized for a first MI and registered in SWEDEHEART were included. Data were linked to Swedish registers. Primary outcomes were all‐cause mortality and nonfatal MI. Associations between LDL‐C and outcomes were assessed using adjusted proportional hazards models.ResultsAmong 63,168 patients (median age, 66 years), the median LDL‐C level was 3.0 mmol/L (interquartile range 2.4–3.6). Patient age and comorbidities increased as LDL‐C decreased. During a median follow‐up of 4.5 years, 10,236 patients died, and 4973 had nonfatal MI. Patients with the highest LDL‐C had a lower risk of mortality (hazard ratio [HR] 0.75; 95% confidence interval [CI] 0.71–0.80). The risk of hospitalization for pneumonia, hip fracture, chronic obstructive pulmonary disease, and new cancer diagnosis was lower with higher LDL‐C (HR range, 0.40–0.81). Patients with the highest LDL‐C had a greater risk of recurrent MI (HR 1.16; 95% CI 1.07–1.26).ConclusionsPatients with the highest LDL‐C levels at MI had the lowest incidence of mortality and morbidity. This seems to reflect lower age at MI, less underlying morbidities, paired with the modifiability of LDL‐C. However, supporting the causal association between LDL‐C and ischemic heart disease, elevated LDL‐C was simultaneously associated with an increased risk of nonfatal MI.

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Section: Discussionmentioning

confidence: 99%

“…Many of these studies report an association between increased age and prevalence of comorbidities with lower LDL-C at MI. Indeed, low LDL-C or total cholesterol has been observed in various disease states [9][10][11][12][13].…”

Section: Introductionmentioning

confidence: 99%

Elevated low‐density lipoprotein cholesterol: An inverse marker of morbidity and mortality in patients with myocardial infarction

et al. 2023

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“…However, The International Journal of Artificial Organs 47 (5) authors who have developed simple risk scores for the related concept of frailty have noted that some scores can represent clinical markers that are predictive of patients who are at risk for frailty. 11 This limitation is counterbalanced by the ability to apply such scores relatively easily in a busy clinical setting, where measuring some validated variables (e.g. grip strength and walk score) is impractical.…”

Section: Discussionmentioning

confidence: 99%

Premorbid functional status in patients requiring veno-arterial extracorporeal membrane oxygenation after cardiac surgery

Bradshaw,

Briscoe,

Sanghavi

et al. 2024

Int J Artif Organs

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Assessment of a patient’s functional status prior to undergoing cardiac surgery may be a useful marker for predicting outcomes when postoperative veno-arterial extracorporeal membrane oxygenation (V-A ECMO) is required. In this short communication, we present retrospective data on 83 patients at a single center who required V-A ECMO after cardiac surgery. Our results did not show a statistically significant association between premorbid functional status and mortality, though age was predictive of mortality. Future studies should explore other markers of functional status and relationships with additional outcomes.

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“…Moreover, the relationship between the occurrence of frailty and the age of patients was not revealed in the above-mentioned study. On the other hand, many authors emphasize the importance of age in the presence of frailty in HF [ 36 , 37 , 38 , 39 , 40 , 41 ]. The frequency of diagnosis of both these problems increases with age and concerns 3.2% of patients aged 65–70 years and over 23% of patients aged 90 and older [ 39 ].…”

Section: Discussionmentioning

confidence: 99%

Employing the Multivariate Edmonton Scale in the Assessment of Frailty Syndrome in Heart Failure

Studzińska

Wąż

Frankiewicz

et al. 2022

JCM

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Background: Frailty syndrome (FS) is a syndrome characterized by a reduction in the body’s physiological reserves as a result of the accumulation of reduced efficiency of many organs and systems. Experts of the Heart Failure Association of the European Society of Cardiology (ECS) emphasize the need to assess frailty in all patients with heart failure (HF). There is no specific scale dedicated to this group of patients. The aim of the study was to assess the occurrence of the frailty syndrome in heart failure using the multidimensional Edmonton Frailty Scale (EFS). Methods: The study included 106 patients diagnosed with heart failure with reduced left ventricular ejection fraction (LVEF < 40%). The average age was 62.6 ± 9.7 years. Most of the patients (84%) studied were men. In 70 people (66%), the cause of heart failure was coronary artery disease. The study group included patients admitted to hospital on a scheduled basis and with exacerbation of heart failure. Frailty was measured using the EFS before discharge from the hospital. Demographic, sociodemographic and clinical data were obtained. A 12-month follow-up period was included in the project. The number of readmissions after 6 and 12 months was assessed. Results: A correlation was observed between the New York Heart Association (NYHA) functional class and the occurrence of frailty—this applies to the assessment at the beginning and at the end of hospitalization. When analyzing the age of the patients in relation to frailty, a statistically significant difference was obtained. The youngest group in terms of age were non-frail patients. Hospitalization of people prone to development of the frailty syndrome and diagnosed with the FS was significantly more often associated with the occurrence of complications during hospital stays. Rehospitalizations for exacerbation of heart failure were much more frequent in patients with frailty. Conclusions: Assessment and monitoring of the state of increased sensitivity to the development of frailty or FS in patients with heart failure should influence the differentiation of clinical management. The Edmonton Questionnaire may be a helpful tool for the assessment of frailty in hospitalized patients with HF.

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A Simple Risk Score Based on Routine Clinical Parameters Can Predict Frailty in Hospitalized Heart Failure Patients

Cited by 8 publications

References 52 publications

Elevated low‐density lipoprotein cholesterol: An inverse marker of morbidity and mortality in patients with myocardial infarction

Elevated low‐density lipoprotein cholesterol: An inverse marker of morbidity and mortality in patients with myocardial infarction

Premorbid functional status in patients requiring veno-arterial extracorporeal membrane oxygenation after cardiac surgery

Employing the Multivariate Edmonton Scale in the Assessment of Frailty Syndrome in Heart Failure

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