Frailty identifies early and non-cardiac healthcare utilization after cardiovascular hospitalization

Frailty is highly prevalent among older adults hospitalized with cardiovascular disease and is associated with adverse clinical outcomes. While its relationship with mortality and readmissions is documented, less is known about how frailty influences post-discharge healthcare utilization patterns. This study aimed to analyze the association between frailty and post-discharge healthcare utilization, defined as time to healthcare events, over 365 days in older adults hospitalized with cardiovascular disease.

This prospective cohort study included patients aged ≥60 years hospitalized with cardiovascular disease between March 2022 and April 2024. Frailty was assessed using the FRAIL scale, alongside functional status (Barthel Index) and routinely collected biochemical markers. Outcomes included time to first cardiology consultation, non-cardiac consultation, emergency department visit, unplanned readmission, and death during 365 days of follow-up. Time-to-event analyses were performed using Kaplan-Meier, and Cox regression models (95% CI; p < 0.05).

A total of 130 patients were included (male: 68.46%; female: 31.54%; mean age: 72.98 ± 7.67 years). Frail patients (35.38%) had longer hospital stays and lower functional status. In univariate analysis, frailty was associated with earlier cardiology visits (HR: 1.57; p = 0.042), non-cardiac consultations (HR: 1.71; p = 0.012), and unplanned readmissions (HR: 2.11; p = 0.030). In multivariate models, frailty remained independently associated with earlier non-cardiac visits (HR: 1.47; p = 0.017), alongside LDL cholesterol levels. Hospital stay emerged as a consistent predictor across multiple outcomes. Mortality during follow-up was low (1.54%) and did not differ by frailty status.

Frailty was associated with earlier post-discharge healthcare use, particularly outside cardiology. Integrating frailty screening with simple functional and biochemical indicators may help identify older adults at risk of increased post-discharge healthcare utilization and support post-discharge planning in ageing populations.