Abstract 20539: Frailty Assessment in Advanced Heart Failure
Introduction: There is growing literature supporting the significance of frailty in a broad array of cardiovascular diseases. To our knowledge, there are no studies specifically examining the application of frailty assessment to an advanced heart failure population.
Methods: Forty consecutive elderly (>65 yrs of age) subjects were enrolled from the heart failure clinic at Montefiore Medical Center, if they had advanced heart failure as defined by: LVEF < 35%, NYHA Class 3 or 4, and a 6 minute walk (6mwt) < 300 meters. At baseline, subjects were assessed for frailty with the Fried Frailty Index, which consists of 5 components: hand grip strength (HGS), 15 meter walk time (WT), weight loss, low physical activity and exhaustion. Each component is assigned a score of 0 or 1 and summed for the total score: 0 = not frail, 1-2 = intermediately frail, ≥3 = frail. Subjects were prospectively followed at 3 month intervals for mortality or heart failure related hospitalizations.
Results: Follow-up was available for 38 subjects at a median length of 437 days (range: 12-549). At baseline, the mean age of the cohort was 74±7 yrs, LVEF 27±7%, and 6mwt 189±80m. None of the patients tested were not frail, 32% (12) were intermediately frail, and 68% (26) were frail. More patients in the frail group (N=7) expired during follow up then those in the intermediately frail group (N=1) although this did not reach statistically significance (Figure; 1). Since there was a limited spectrum of frailty in this cohort, HGS and WT were assessed as continuous measures for association with outcomes. Both objective tools demonstrated a strong trend towards mortality (p=0.08). There was no association between the composite or individual score and hospitalizations.
Conclusions: In this pilot study of frailty assessment in advanced heart failure, the objective tools of WT and HGS tended to be associated with mortality. These preliminary results warrant further investigation.
Author Disclosures: S. Gunda: None. F. Kargoli: None. K. Gentile: None. J.J. Shin: None. S.R. Patel: None.
- © 2014 by American Heart Association, Inc.