Frailty Scale Captures Multidimensional Vulnerability and Predicts Mortality in Heart Failure

Area of Science:

• Cardiology
• Geriatrics
• Clinical Assessment

Background:

• Frailty is common in heart failure patients, impacting outcomes.
• The Clinical Frailty Scale's (CFS) utility in assessing physical/cognitive decline and prognosis in heart failure is unclear.

Purpose of the Study:

• To evaluate how well the CFS reflects physical and cognitive function.
• To assess the CFS's association with 2-year all-cause mortality in hospitalized heart failure patients.

Main Methods:

• Utilized data from 3,905 hospitalized heart failure patients in the JROADHF-NEXT registry.
• Assessed physical function (gait speed, chair stand, SPPB, grip strength, 6MWD) and cognitive function (Mini-Cog).
• Stratified patients by CFS scores (1-2, 3, 4, 5, 6, 7-9) and analyzed 2-year all-cause mortality.

Main Results:

• Physical function and cognitive scores declined with increasing CFS severity.
• Mortality increased stepwise with higher CFS scores; 18.6% died within 2 years.
• The CFS improved prognostic model discrimination beyond SPPB and Mini-Cog.

Conclusions:

• The CFS is an independent predictor of 2-year mortality in heart failure.
• The CFS serves as a comprehensive measure of physical and cognitive frailty.
• The CFS is a practical screening tool for heart failure management.