Temporal Trends in Mortality and Hospitalization Risk in Patients With Heart Failure According to the Hospital Frailty Risk Score
Background Heart failure (HF) and frailty often coexist. However, it is unknown how the interplay between HF and frailty at HF onset impacts prognosis of frail patients with HF and how this has evolved over time. Methods and Results We identified 131 235 patients with new‐onset HF (median age 74 yea...
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| Format: | Article |
| Language: | English |
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Wiley
2025-02-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
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| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.124.037973 |
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| author | Noor K. Abassi Nina Nouhravesh Mariam Elmegaard Marte Austreim Deewa Zahir Caroline Hartwell Garred Jawad H. Butt Camilla Fuchs Andersen Jarl E. Strange Caroline Sindet‐Pedersen Daniel M. Christensen Emil Fosbøl Charlotte Andersson Lars Køber Morten Schou |
| author_facet | Noor K. Abassi Nina Nouhravesh Mariam Elmegaard Marte Austreim Deewa Zahir Caroline Hartwell Garred Jawad H. Butt Camilla Fuchs Andersen Jarl E. Strange Caroline Sindet‐Pedersen Daniel M. Christensen Emil Fosbøl Charlotte Andersson Lars Køber Morten Schou |
| author_sort | Noor K. Abassi |
| collection | DOAJ |
| description | Background Heart failure (HF) and frailty often coexist. However, it is unknown how the interplay between HF and frailty at HF onset impacts prognosis of frail patients with HF and how this has evolved over time. Methods and Results We identified 131 235 patients with new‐onset HF (median age 74 years, 39.7% women) from Danish nationwide registers in 1999 to 2017. Stratification according to the Hospital Frailty Risk Score resulted in (1) 102 635 (78%) nonfrail, (2) 26 054 (20%) moderately frail, and (3) 2609 (2%) severely frail patients. The proportion of moderately frail patients increased from 13.2% to 24.9%. Five‐year absolute risks of all‐cause mortality, HF hospitalization, and non‐HF hospitalization were calculated using the Kaplan‐Meier and Aalen‐Johansen estimators. From 1999 to 2002 to 2003 to 2017, all‐cause mortality risk (95% CI) declined from 56.4% (55.8%–57.0%) to 33.3% (32.6%–34.1%), 79.8% (78.5%–81.0%) to 58.6% (57.2%–60.1%), and 90.8% (85.6%–96.0%) to 79.8% (76.4%–83.2%) in nonfrail, moderately frail, and severely frail patients, respectively. HF hospitalization risk remained almost constant over the study period. Non‐HF hospitalization risk declined from 74.0% (73.5%–74.5%) to 65.8% (65.0%–66.5%) in nonfrail patients and remained stable overall in moderately frail and severely frail patients over the study period. Conclusions We observed an increase in frail patients. Mortality decreased for all frailty groups but remained high for severely frail patients. These findings indicate the need for further evidence on the optimization of care for frail patients with HF, and future research should address the development of comprehensive management strategies, integrating frailty assessment into standard clinical care and focused care for older patients with HF. |
| format | Article |
| id | doaj-art-9d2ed9ae6ad34efab3042ecf6e6dee30 |
| institution | Kabale University |
| issn | 2047-9980 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj-art-9d2ed9ae6ad34efab3042ecf6e6dee302025-02-04T11:00:01ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802025-02-0114310.1161/JAHA.124.037973Temporal Trends in Mortality and Hospitalization Risk in Patients With Heart Failure According to the Hospital Frailty Risk ScoreNoor K. Abassi0Nina Nouhravesh1Mariam Elmegaard2Marte Austreim3Deewa Zahir4Caroline Hartwell Garred5Jawad H. Butt6Camilla Fuchs Andersen7Jarl E. Strange8Caroline Sindet‐Pedersen9Daniel M. Christensen10Emil Fosbøl11Charlotte Andersson12Lars Køber13Morten Schou14Department of Cardiology Herlev‐Gentofte University Hospital Copenhagen DenmarkDepartment of Cardiology Herlev‐Gentofte University Hospital Copenhagen DenmarkDepartment of Cardiology Herlev‐Gentofte University Hospital Copenhagen DenmarkDepartment of Cardiology Herlev‐Gentofte University Hospital Copenhagen DenmarkDepartment of Cardiology Herlev‐Gentofte University Hospital Copenhagen DenmarkDepartment of Cardiology Herlev‐Gentofte University Hospital Copenhagen DenmarkDepartment of Cardiology Roskilde Hospital Roskilde DenmarkDepartment of Cardiology Herlev‐Gentofte University Hospital Copenhagen DenmarkDepartment of Cardiology Herlev‐Gentofte University Hospital Copenhagen DenmarkDepartment of Cardiology Herlev‐Gentofte University Hospital Copenhagen DenmarkDepartment of Cardiology Herlev‐Gentofte University Hospital Copenhagen DenmarkDepartment of Cardiology, Rigshospitalet University of Copenhagen Copenhagen DenmarkCardiovascular Division Brigham & Women’s hospital and Harvard Medical School Boston MA USADepartment of Cardiology, Rigshospitalet University of Copenhagen Copenhagen DenmarkDepartment of Cardiology Herlev‐Gentofte University Hospital Copenhagen DenmarkBackground Heart failure (HF) and frailty often coexist. However, it is unknown how the interplay between HF and frailty at HF onset impacts prognosis of frail patients with HF and how this has evolved over time. Methods and Results We identified 131 235 patients with new‐onset HF (median age 74 years, 39.7% women) from Danish nationwide registers in 1999 to 2017. Stratification according to the Hospital Frailty Risk Score resulted in (1) 102 635 (78%) nonfrail, (2) 26 054 (20%) moderately frail, and (3) 2609 (2%) severely frail patients. The proportion of moderately frail patients increased from 13.2% to 24.9%. Five‐year absolute risks of all‐cause mortality, HF hospitalization, and non‐HF hospitalization were calculated using the Kaplan‐Meier and Aalen‐Johansen estimators. From 1999 to 2002 to 2003 to 2017, all‐cause mortality risk (95% CI) declined from 56.4% (55.8%–57.0%) to 33.3% (32.6%–34.1%), 79.8% (78.5%–81.0%) to 58.6% (57.2%–60.1%), and 90.8% (85.6%–96.0%) to 79.8% (76.4%–83.2%) in nonfrail, moderately frail, and severely frail patients, respectively. HF hospitalization risk remained almost constant over the study period. Non‐HF hospitalization risk declined from 74.0% (73.5%–74.5%) to 65.8% (65.0%–66.5%) in nonfrail patients and remained stable overall in moderately frail and severely frail patients over the study period. Conclusions We observed an increase in frail patients. Mortality decreased for all frailty groups but remained high for severely frail patients. These findings indicate the need for further evidence on the optimization of care for frail patients with HF, and future research should address the development of comprehensive management strategies, integrating frailty assessment into standard clinical care and focused care for older patients with HF.https://www.ahajournals.org/doi/10.1161/JAHA.124.037973all‐cause deathfrailtyheart failurehospitalization risktime trend |
| spellingShingle | Noor K. Abassi Nina Nouhravesh Mariam Elmegaard Marte Austreim Deewa Zahir Caroline Hartwell Garred Jawad H. Butt Camilla Fuchs Andersen Jarl E. Strange Caroline Sindet‐Pedersen Daniel M. Christensen Emil Fosbøl Charlotte Andersson Lars Køber Morten Schou Temporal Trends in Mortality and Hospitalization Risk in Patients With Heart Failure According to the Hospital Frailty Risk Score Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease all‐cause death frailty heart failure hospitalization risk time trend |
| title | Temporal Trends in Mortality and Hospitalization Risk in Patients With Heart Failure According to the Hospital Frailty Risk Score |
| title_full | Temporal Trends in Mortality and Hospitalization Risk in Patients With Heart Failure According to the Hospital Frailty Risk Score |
| title_fullStr | Temporal Trends in Mortality and Hospitalization Risk in Patients With Heart Failure According to the Hospital Frailty Risk Score |
| title_full_unstemmed | Temporal Trends in Mortality and Hospitalization Risk in Patients With Heart Failure According to the Hospital Frailty Risk Score |
| title_short | Temporal Trends in Mortality and Hospitalization Risk in Patients With Heart Failure According to the Hospital Frailty Risk Score |
| title_sort | temporal trends in mortality and hospitalization risk in patients with heart failure according to the hospital frailty risk score |
| topic | all‐cause death frailty heart failure hospitalization risk time trend |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.124.037973 |
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