The effect of frailty on 30-day mortality risk in older patients with acute heart failure attended in the Emergency Department

Abstract

Objective

To determine the effect of frailty on risk of 30-day mortality in non-severely disabled older patients with acute heart failure (AHF) attended in emergency departments (EDs).

Methodology

The Frailty-AHF Study is a retrospective analysis of a multicentre, observational, prospective, cohort study (Older-AHF Register). This study included consecutive patients ≥ 65 years of age without severe functional dependence or dementia attended for AHF in 3 Spanish EDs during 4 months. Frailty was defined by frailty phenotype as the presence of 3 or more domains. Baseline and episode characteristics and 30-day mortality were collected in all the patients.

Results

A total of 465 patients with a mean age of 82 (SD 7) years were included, 283 (61.0%) being female and 225 (51.3%) with severe comorbidity (Charlson index ≥ 3). Frailty was present in 169 (36.3%). The rate of 30-day mortality was 7.3%. Frailty adjusted for potential confounding factors was an independent factor associated with 30-day mortality (adjusted HR=2.5; 95%CI 1.0-6.0; p=0.047).

Conclusion

The presence of frailty is an independent risk factor of 30-day mortality in non-severe dependent older patients attended with AHF in EDs.

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