Assessment of frailty in patients with heart failure: A new Heart Failure Frailty Score developed by Delphi consensus
Abstract Aims The Heart Failure Frailty Score (HFFS) is a novel, multidimensional tool to assess frailty in patients with heart failure (HF). It has been developed to overcome limitations of existing frailty assessment tools while being practical for clinical use. The HFFS reflects the concept of fr...
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2025-06-01
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| Series: | ESC Heart Failure |
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| Online Access: | https://doi.org/10.1002/ehf2.15187 |
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| author | Cristiana Vitale Emmanuelle Berthelot Andrew J.S. Coats Hill Loreena Nancy M. Albert Michal Tkaczyszyn Stamatis Adamopoulos Lisa Anderson Markus S. Anker Stefan D. Anker Derek Bell Tuvia Ben‐Gal Vasiliki Bistola Biykem Bozkurt Poppy Brooks Miguel Camafort Juan Jesus Carrero Ovidiu Chioncel Dong‐Ju Choi Wook‐Jin Chung Wolfram Doehner Daniel Fernández‐Bergés Roberto Ferrari Mona Fiuzat Juan Esteban Gomez‐Mesa Finn Gustafsson Ewa Jankowska Seok‐Min Kang Koichiro Kinugawa Kamlesh Khunti F.D. Richard Hobbs Christopher Lee Yuri Lopatin Matthew Maddocks Giuseppe Maltese Elena Marques‐Sule Yuya Matsue Òscar Miró Brenda Moura Massimo Piepoli Piotr Ponikowski Giovanni Pulignano Amina Rakisheva Robin Ray Angela Sciacqua Petar Seferovic Trinidad Sentandreu‐Mañó Shirley Sze Alan Sinclair Anna Strömberg Olga Theou Hiroyuki Tsutsui Izabella Uchmanowicz Maria Teresa Vidan Maurizio Volterrani Stephan vonHaehling Byungsu Yoo Jian Zhang Yuhui Zhang Marco Metra Giuseppe Massimo Claudio Rosano |
| author_facet | Cristiana Vitale Emmanuelle Berthelot Andrew J.S. Coats Hill Loreena Nancy M. Albert Michal Tkaczyszyn Stamatis Adamopoulos Lisa Anderson Markus S. Anker Stefan D. Anker Derek Bell Tuvia Ben‐Gal Vasiliki Bistola Biykem Bozkurt Poppy Brooks Miguel Camafort Juan Jesus Carrero Ovidiu Chioncel Dong‐Ju Choi Wook‐Jin Chung Wolfram Doehner Daniel Fernández‐Bergés Roberto Ferrari Mona Fiuzat Juan Esteban Gomez‐Mesa Finn Gustafsson Ewa Jankowska Seok‐Min Kang Koichiro Kinugawa Kamlesh Khunti F.D. Richard Hobbs Christopher Lee Yuri Lopatin Matthew Maddocks Giuseppe Maltese Elena Marques‐Sule Yuya Matsue Òscar Miró Brenda Moura Massimo Piepoli Piotr Ponikowski Giovanni Pulignano Amina Rakisheva Robin Ray Angela Sciacqua Petar Seferovic Trinidad Sentandreu‐Mañó Shirley Sze Alan Sinclair Anna Strömberg Olga Theou Hiroyuki Tsutsui Izabella Uchmanowicz Maria Teresa Vidan Maurizio Volterrani Stephan vonHaehling Byungsu Yoo Jian Zhang Yuhui Zhang Marco Metra Giuseppe Massimo Claudio Rosano |
| author_sort | Cristiana Vitale |
| collection | DOAJ |
| description | Abstract Aims The Heart Failure Frailty Score (HFFS) is a novel, multidimensional tool to assess frailty in patients with heart failure (HF). It has been developed to overcome limitations of existing frailty assessment tools while being practical for clinical use. The HFFS reflects the concept of frailty as a multidimensional, dynamic and potentially reversible state, which increases vulnerability to stressors and risk of poor outcomes in patients with HF. Methods and results The HFFS was developed through a Delphi consensus process involving 54 international experts. This approach involved iterative rounds of questionnaires and interviews, where a panel of experts provided their opinions on specific questions prepared by the Steering Committee. The experts were invited to vote and share their views anonymously, using a 5‐point Likert scale over iterative rounds. An 80% threshold was set for agreement or disagreement for each statement. Twenty‐two variables from four domains (clinical, functional, psycho‐cognitive and social) have been selected for inclusion in the HFFS after the third round of the Delphi process. A shorter version (S‐HFFS), including 10 variables, has also been developed for daily clinical use. Conclusions The HFFS is a new multidimensional tool for the identification of frailty in patients with HF. It should also enables healthcare providers to identify potential ‘red flags’ for frailty in order to develop personalized care plans. The next step will be to validate the new score in patients with HF. |
| format | Article |
| id | doaj-art-91c48ebee98c4ea9af707bb732d14336 |
| institution | OA Journals |
| issn | 2055-5822 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Wiley |
| record_format | Article |
| series | ESC Heart Failure |
| spelling | doaj-art-91c48ebee98c4ea9af707bb732d143362025-08-20T02:16:01ZengWileyESC Heart Failure2055-58222025-06-011231818183110.1002/ehf2.15187Assessment of frailty in patients with heart failure: A new Heart Failure Frailty Score developed by Delphi consensusCristiana Vitale0Emmanuelle Berthelot1Andrew J.S. Coats2Hill Loreena3Nancy M. Albert4Michal Tkaczyszyn5Stamatis Adamopoulos6Lisa Anderson7Markus S. Anker8Stefan D. Anker9Derek Bell10Tuvia Ben‐Gal11Vasiliki Bistola12Biykem Bozkurt13Poppy Brooks14Miguel Camafort15Juan Jesus Carrero16Ovidiu Chioncel17Dong‐Ju Choi18Wook‐Jin Chung19Wolfram Doehner20Daniel Fernández‐Bergés21Roberto Ferrari22Mona Fiuzat23Juan Esteban Gomez‐Mesa24Finn Gustafsson25Ewa Jankowska26Seok‐Min Kang27Koichiro Kinugawa28Kamlesh Khunti29F.D. Richard Hobbs30Christopher Lee31Yuri Lopatin32Matthew Maddocks33Giuseppe Maltese34Elena Marques‐Sule35Yuya Matsue36Òscar Miró37Brenda Moura38Massimo Piepoli39Piotr Ponikowski40Giovanni Pulignano41Amina Rakisheva42Robin Ray43Angela Sciacqua44Petar Seferovic45Trinidad Sentandreu‐Mañó46Shirley Sze47Alan Sinclair48Anna Strömberg49Olga Theou50Hiroyuki Tsutsui51Izabella Uchmanowicz52Maria Teresa Vidan53Maurizio Volterrani54Stephan vonHaehling55Byungsu Yoo56Jian Zhang57Yuhui Zhang58Marco Metra59Giuseppe Massimo Claudio Rosano60Department of Human Sciences and Promotion of Quality of Life, San Raffaele Open University of Rome Rome ItalyHospital Bicetre Le‐Kremlin Bicetre FranceHeart Research Institute Sydney AustraliaSchool of Nursing & Midwifery Queen's University Belfast UKNursing Institute and Linda H. Kaufman Center for Heart Failure Treatment and Recovery, Cleveland Clinic Cleveland Ohio USADivision of Translational Cardiology and Clinical Registries, Institute of Heart Diseases Wroclaw Medical University Wroclaw PolandHeart Failure and Transplant Unit Onassis Cardiac Surgery Centre Athens GreeceCardiovascular Clinical Academic Group, Molecular and Clinical Sciences Research Institute University of London and St George's University Hospitals NHS Foundation Trust London UKDepartment of Cardiology CBF German Heart Center Charité, DZHK, BCRT University Medicine Berlin FU and HU Berlin GermanyDepartment of Cardiology (CVK) of German Heart Center Charité; Berlin Institute of Health Center for Regenerative Therapies (BCRT), German Centre for Cardiovascular Research (DZHK) partner site Berlin Charité Universitätsmedizin Berlin GermanyNational Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care (CLAHRC) London UKHeart Failure Unit, Cardiology Department, Rabin Medical Center, Petah Tikva and Faculty of Medicine Tel Aviv University Tel Aviv IsraelDepartment of Cardiology, Attikon University Hospital National Kapodistrian University of Athens Medical School Athens GreeceWinters Center for Heart Failure, Cardiovascular Research Institute Baylor College of Medicine and DeBakey VA Medical Center Houston Texas USARoyal Devon University Healthcare NHS Foundation Trust Barnstaple UKHeart Failure Unit, Internal Medicine Department, Hospital Clínic, IDIBAPS University of Barcelona Barcelona SpainDepartment of Medical Epidemiology and Biostatistics Karolinska Institutet Stockholm SwedenEmergency Institute for Cardiovascular Diseases ‘Prof. C.C. Iliescu’ University of Medicine Carol Davila Bucharest RomaniaSeoul National University Bundang Hospital Seongnam South KoreaDepartment of Cardiovascular Medicine Gachon University Gil Medical Center Incheon KoreaBerlin Institute of Health Center for Regenerative Therapies and Deutsches Herzzentrum der Charité, Department Cardiology (Virchow Klinikum), German Centre for Cardiovascular Research Partner Site Berlin and Center for Stroke Research Berlin Charité ‐ Universitätsmedizin Berlin Berlin GermanyResearch Unit of Don Benito‐Villanueva de la Serena Health Area, SES‐Fundesalud, Villanueva de la Serena, Spain University Institute for Biosanitary Research of Extremadura (INUBE) Badajoz SpainCentro Cardiologico Universitario di Ferrara University of Ferrara Ferrara ItalyDivision of Cardiology Duke University Durham North Carolina USACardiology Department, Fundacion Valle del Lili, Health Sciences Department Universidad Icesi Cali ColombiaDepartment of Cardiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark; Institute of Heart Diseases Wroclaw Medical University, University Hospital Wroclaw PolandDivision of Translational Cardiology and Clinical Registries, Institute of Heart Diseases Wroclaw Medical University Wroclaw PolandDivision of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital Yonsei University Seoul Republic of KoreaThe Second Department of Internal Medicine University of Toyama Toyama JapanDiabetes Research Centre University of Leicester Leicester UKNuffield Department of Primary Care Health Sciences University of Oxford Oxford UKWilliam F. Conell School of Nursing Boston College Newton Massachusetts USARegional Cardiology Centre Volgograd State Medical University Volgograd Russian FederationCicely Saunders Institute of Palliative Care, Policy and Rehabilitation King's College London London UKDepartment of Diabetes and Endocrinology Epsom & St Helier University Hospitals Surrey UKDepartment of Physiotherapy University of Valencia Valencia SpainDepartment of Cardiovascular Biology and Medicine Juntendo University Graduate School of Medicine Tokyo JapanEmergency Department, Hospital Clínic, IDIBAPS University of Barcelona Barcelona SpainFaculty of Medicine of Porto Armed Forces Hospital Porto PortugalClinical Cardiology, IRCCS Policlinico San Donato Milano ItalyInstitute of Heart Diseases Wroclaw Medical University Wroclaw PolandHeart Failure Clinic, Division of Cardiology/Coronary Care Unit San Camillo Hospital Rome ItalyCardiology Department City Cardiology Center Almaty KazakhstanCardiovascular Clinical Academic Group, Molecular and Clinical Sciences Research Institute University of London and St George's University Hospitals NHS Foundation Trust London UKInternal Medicine, Cardiovascular and Metabolic Diseases, Geriatrics Division, University Hospital R. Dulbecco University Magna Graecia of Catanzaro Catanzaro ItalyUniversity Medical Center, Medical Faculty University of Belgrade Serbian Academy of Sciences and Arts Belgrade SerbiaDepartment of Physiotherapy, Advanced Research Methods Applied to Quality of Life Promotion (ARMAQoL) University of Valencia Valencia SpainNIHR Leicester Biomedical Research Centre University of Leicester, Glenfield Hospital Leicester UKKing's College, London, and Foundation for Diabetes Research in Older People (fDROP) Droitwich Spa UKDepartment of Health, Medicine and Caring Sciences and Department of Cardiology Linköping University Linköping SwedenSchool of Physiotherapy and Department of Medicine Dalhousie University Halifax CanadaInternational University of Health and Welfare Fukuoka JapanFaculty of Nursing and Midwives Wroclaw Medical University Wrocław PolandGeriatric Department, Hospital General Universitario Gregorio Maranón, Madrid, Spain; Biomedical Research Networking Center on Frailty and Healthy Aging, CIBERFES Madrid SpainDepartment of Human Sciences and Promotion of Quality of Life, San Raffaele Open University of Rome Rome ItalyDepartment of Cardiology and Pneumology University of Göttingen Medical Center, DZHK (German Center for Cardiovascular Research) (DZHK), Partner Site Lower Saxony Göttingen Göttingen GermanyDivision of Cardiology, Wonju College of Medicine Yonsei University Yonsei KoreaState Key Laboratory of Cardiovascular Disease, Heart Failure Center, Fuwai Hospital, National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences and Peking Union Medical College Beijing ChinaFuwai Hospital & National Center for Cardiovascular Diseases Beijing ChinaDirector Cardiology Unit ASST Spedali Civili and University of Brescia Brescia ItalyDepartment of Human Sciences and Promotion of Quality of Life, San Raffaele Open University of Rome Rome ItalyAbstract Aims The Heart Failure Frailty Score (HFFS) is a novel, multidimensional tool to assess frailty in patients with heart failure (HF). It has been developed to overcome limitations of existing frailty assessment tools while being practical for clinical use. The HFFS reflects the concept of frailty as a multidimensional, dynamic and potentially reversible state, which increases vulnerability to stressors and risk of poor outcomes in patients with HF. Methods and results The HFFS was developed through a Delphi consensus process involving 54 international experts. This approach involved iterative rounds of questionnaires and interviews, where a panel of experts provided their opinions on specific questions prepared by the Steering Committee. The experts were invited to vote and share their views anonymously, using a 5‐point Likert scale over iterative rounds. An 80% threshold was set for agreement or disagreement for each statement. Twenty‐two variables from four domains (clinical, functional, psycho‐cognitive and social) have been selected for inclusion in the HFFS after the third round of the Delphi process. A shorter version (S‐HFFS), including 10 variables, has also been developed for daily clinical use. Conclusions The HFFS is a new multidimensional tool for the identification of frailty in patients with HF. It should also enables healthcare providers to identify potential ‘red flags’ for frailty in order to develop personalized care plans. The next step will be to validate the new score in patients with HF.https://doi.org/10.1002/ehf2.15187Heart failureFrailtyManagementPrognosisScore |
| spellingShingle | Cristiana Vitale Emmanuelle Berthelot Andrew J.S. Coats Hill Loreena Nancy M. Albert Michal Tkaczyszyn Stamatis Adamopoulos Lisa Anderson Markus S. Anker Stefan D. Anker Derek Bell Tuvia Ben‐Gal Vasiliki Bistola Biykem Bozkurt Poppy Brooks Miguel Camafort Juan Jesus Carrero Ovidiu Chioncel Dong‐Ju Choi Wook‐Jin Chung Wolfram Doehner Daniel Fernández‐Bergés Roberto Ferrari Mona Fiuzat Juan Esteban Gomez‐Mesa Finn Gustafsson Ewa Jankowska Seok‐Min Kang Koichiro Kinugawa Kamlesh Khunti F.D. Richard Hobbs Christopher Lee Yuri Lopatin Matthew Maddocks Giuseppe Maltese Elena Marques‐Sule Yuya Matsue Òscar Miró Brenda Moura Massimo Piepoli Piotr Ponikowski Giovanni Pulignano Amina Rakisheva Robin Ray Angela Sciacqua Petar Seferovic Trinidad Sentandreu‐Mañó Shirley Sze Alan Sinclair Anna Strömberg Olga Theou Hiroyuki Tsutsui Izabella Uchmanowicz Maria Teresa Vidan Maurizio Volterrani Stephan vonHaehling Byungsu Yoo Jian Zhang Yuhui Zhang Marco Metra Giuseppe Massimo Claudio Rosano Assessment of frailty in patients with heart failure: A new Heart Failure Frailty Score developed by Delphi consensus ESC Heart Failure Heart failure Frailty Management Prognosis Score |
| title | Assessment of frailty in patients with heart failure: A new Heart Failure Frailty Score developed by Delphi consensus |
| title_full | Assessment of frailty in patients with heart failure: A new Heart Failure Frailty Score developed by Delphi consensus |
| title_fullStr | Assessment of frailty in patients with heart failure: A new Heart Failure Frailty Score developed by Delphi consensus |
| title_full_unstemmed | Assessment of frailty in patients with heart failure: A new Heart Failure Frailty Score developed by Delphi consensus |
| title_short | Assessment of frailty in patients with heart failure: A new Heart Failure Frailty Score developed by Delphi consensus |
| title_sort | assessment of frailty in patients with heart failure a new heart failure frailty score developed by delphi consensus |
| topic | Heart failure Frailty Management Prognosis Score |
| url | https://doi.org/10.1002/ehf2.15187 |
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