Frailty in elderly patients with acute heart failure increases readmission

Abstract

Background: The readmission rate of heart failure (HF) patients has not decreased during the past few years.

Objectives: The purpose of this study was to examine whether factors such as left ventricular ejection fraction (LVEF) and frailty are associated with readmission and number of readmissions in HF patients.

Methods: First, a propensity score matching method was used to adjust for confounding factors for readmission. Cox regression analysis was conducted to determine the factors that influenced readmission. Finally, multiple regression analysis was conducted to determine the factors that influenced the number of readmissions. The independent variables were basic and medical information, physical structure, physical functions, and activity for both Cox regression analysis and multiple regression analysis.

Results: After matching based on the propensity score, 18 out of 18 (100.0%) patients in the readmission group (age: 85.0 ± 6.9 years, female rate: 50.0%, body mass index: 21.7 ± 3.4 kg/m²) and 18 out of 51 (35.3%) patients in the nonreadmission group (age: 84.3 ± 8.6, female rate: 50.0%, body mass index: 21.8 ± 4.5 kg/m²) were eligible for analysis. Cox regression analysis (hazard ratios) showed that sex (0.16), geriatric nutritional risk index (1.02), and degree of frailty (11.44) were extracted as significant factors. Multiple regression analysis (standardized regression coefficients) showed that the estimated glomerular filtration rate (-0.40), LVEF (-0.32), and degree of frailty (0.29) were extracted as significant factors.

Conclusion: Our results suggest that frailty is important to reduce the readmission rate and number of readmissions of the acute HF patients.

Keywords: Frailty; Heart failure; Number of readmissions; Readmission.