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Prognostic Value of the Kihon Checklist in Older Cardiovascular Disease Patients
Kakeru Hashimoto1, Akihiro Hirashiki2, Koki Kawamura1
1Department of Rehabilitation, National Center for Geriatrics and Gerontology, Obu, Japan.
Insights
The Kihon checklist (KCL) score effectively predicts mortality in older adults with cardiovascular disease (CVD). A higher KCL score indicates a worse prognosis, aiding in risk stratification for CVD patients.
Area of Science:
- Gerontology
- Cardiology
- Public Health
Background:
- Frailty assessment is crucial for older adults, but existing indicators lack suitability for cardiovascular disease (CVD).
- The Kihon checklist (KCL) is a comprehensive frailty assessment tool.
- Identifying reliable frailty indicators for CVD patients is essential for improving prognosis.
Purpose of the Study:
- To evaluate the association between the Kihon checklist (KCL) score and the prognosis of older adults diagnosed with cardiovascular disease (CVD).
- To determine if KCL score can serve as a prognostic indicator in elderly CVD patients.
Main Methods:
- A cohort of 336 hospitalized adults aged 65 years and older with CVD were assessed using the KCL.
- Data on left ventricular ejection fraction (LVEF), brain natriuretic peptide (BNP), and clinical outcomes (all-cause death, CVD composite endpoint, CVD death, CVD hospitalization) were collected.
- Survival time analysis (Kaplan-Meier) and Cox proportional hazards analyses were employed to examine the relationship between KCL score and prognosis.
Main Results:
- A KCL cutoff score of 8 was identified. Survival analysis revealed significant differences in all-cause death, CVD composite endpoint, and CVD death between groups (P < 0.001).
- A KCL score of 8 or higher was significantly associated with increased risk of all-cause death (HR, 2.731) and CVD death (HR, 2.875).
- In the heart failure (HF) subgroup, the association between a high KCL score and adverse outcomes was not statistically significant.
Conclusions:
- The total KCL score is a significant predictor of mortality in the overall cohort of older adults with CVD.
- While the KCL score shows prognostic value for CVD patients, its association in the heart failure subgroup alone was borderline.
- The KCL may serve as a valuable tool for assessing frailty and predicting outcomes in elderly individuals with cardiovascular disease.
Objectives:
Of various frailty indicators, none are suitable for cardiovascular disease (CVD). We aimed to verify the association between the Kihon checklist (KCL) score and prognosis of older adults with CVD.
Methods:
Participants (n = 336) were adults with CVD (aged ≥ 65 years, mean age 81 years) who required hospitalization. They were assessed with the KCL, and data were obtained for left ventricular ejection fraction (LVEF) and brain natriuretic peptide (BNP) at discharge, and the occurrence of all-cause death, CVD composite endpoint, CVD death, and CVD hospitalization after discharge. The cutoff value of the KCL score for all-cause death was calculated using receiver operating characteristic analysis, and participants were divided into two groups. The relationship between KCL score and prognosis was examined using survival time (Kaplan-Meier method) and Cox proportional hazards analyses.
Results:
The KCL cutoff value was 8 (KCL < 8, n=155). Survival time analysis showed significant differences in all-cause death, CVD composite endpoint, and CVD death (log-rank test: P < 0.001, each). Cox proportional hazards analysis showed that KCL score of 8 or higher was significantly associated with all-cause death [hazard ratio (HR), 2.731; 95% confidence interval (CI), 1.202-6.205] and CVD death (HR, 2.875; 95% CI, 1.124-7.353). In the HF only group, KCL score of 8 or higher was not significantly associated with all-cause death, CVD death, or CVD composite endpoint.
Conclusions:
Total KCL score was associated with mortality in the overall cohort of older adults with CVD, although the association in the HF subgroup alone showed a borderline trend.
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