Comparative prognostic value of three frailty-assessment tools in older patients with heart failure: post hoc analysis of the FRAGILE-HF cohort.

Background In older patients with heart failure, frailty assessment tools potentially have different prognostic value for all-cause mortality. Objective To compare the Frailty Screening Index (FSI), FRAIL scale and Fried phenotype. Design Post hoc analysis of the FRAGILE-HF study. Subjects Hospitali...

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Publicado en:Age & Ageing Vol. 55; no. 2; pp. 1 - 12
Autores principales: Nakade, Taisuke, Maeda, Daichi, Matsue, Yuya, Kagiyama, Nobuyuki, Fujimoto, Yudai, Ikeda, Yoshiaki, Sunayama, Tsutomu, Taishi, Dotare, Jujo, Kentaro, Saito, Kazuya
Formato: Artículo
Publicado: Oxford University Press / USA Feb2026
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Acceso en línea:Ver este registro en EBSCOhost
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        10.1093/ageing/afag031
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        atl: Comparative prognostic value of three frailty-assessment tools in older patients with heart failure: post hoc analysis of the FRAGILE-HF cohort.
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          Nakade, Taisuke
          Maeda, Daichi
          Matsue, Yuya
          Kagiyama, Nobuyuki
          Fujimoto, Yudai
          Ikeda, Yoshiaki
          Sunayama, Tsutomu
          Taishi, Dotare
          Jujo, Kentaro
          Saito, Kazuya
        affil:
          Department of Cardiovascular Biology and Medicine, Juntendo University School of Medicine, Graduate School of Medicine, Tokyo, Japan
          Department of Cardiovascular Biology and Medicine, Juntendo University School of Medicine, Graduate School of Medicine, Tokyo, JapanDepartment of Cardiology, Osaka Medical and Pharmaceutical University, Takatsuki, Osaka, Japan
          Department of Cardiovascular Biology and Medicine, Juntendo University School of Medicine, Graduate School of Medicine, Tokyo, JapanDepartment of Cardiology, Sakakibara Heart Institute of Okayama, Okayama, Japan
          Department of Cardiology, Nishiarai Heart Centre Hospital, Tokyo, Japan
          Department of Rehabilitation, Sakakibara Heart Institute of Okayama, Okayama, Japan
      su:
        Japan
        Health status indicators
        Interviewing
        Age distribution
        Decision making
        Causes of death
        Hospital care of older people
        Psychosocial factors
        Old age
        Skeletal muscle physiology
        Predictive tests
        Risk assessment
        Receiver operating characteristic curves
        Data analysis
        Research funding
        Frail elderly
        Questionnaires
        Fisher exact test
        Kruskal-Wallis Test
        Hemoglobins
        Heart failure
        Peptide hormones
        Disease prevalence
        Functional status
        Chi-squared test
        Descriptive statistics
        Kaplan-Meier estimator
        Electrocardiography
        Log-rank test
        Geriatric assessment
        Statistics
        One-way analysis of variance
        Comparative studies
        Prognosis
        Exercise tests
        Confidence intervals
        Body movement
        Walking speed
        Data analysis software
        Phenotypes
        Proportional hazards models
        Time
        Sensitivity & specificity (Statistics)
        Grip strength
        Muscle contraction
        Nonparametric statistics
      sug:
        subj:
          Health status indicators
          Interviewing
          Age distribution
          Decision making
          Causes of death
          Hospital care of older people
          Psychosocial factors
          Old age
          Japan
          Skeletal muscle physiology
          Predictive tests
          Risk assessment
          Receiver operating characteristic curves
          Data analysis
          Research funding
          Frail elderly
          Questionnaires
          Fisher exact test
          Kruskal-Wallis Test
          Hemoglobins
          Heart failure
          Peptide hormones
          Disease prevalence
          Functional status
          Chi-squared test
          Descriptive statistics
          Kaplan-Meier estimator
          Electrocardiography
          Log-rank test
          Geriatric assessment
          Statistics
          One-way analysis of variance
          Comparative studies
          Prognosis
          Exercise tests
          Confidence intervals
          Body movement
          Walking speed
          Data analysis software
          Phenotypes
          Proportional hazards models
          Time
          Sensitivity & specificity (Statistics)
          Grip strength
          Muscle contraction
          Nonparametric statistics
      keyword:
        copyrightHolder:British Geriatrics Society
        copyrightYear:2026
        foam stability index
        frail elderly
        frailty
        fried foods
        heart failure
        https://dx.doi.org/10.1093/ageing/afag031
        inLanguage:en
        mortality
        older adult
        older people
        patient prognosis
        phenotype
        physical functional performance
        prognosis
        publisher:Oxford University Press
        sameAs:https://pubmed.ncbi.nlm.nih.gov/41734100/
        copyrightHolder:British Geriatrics Society
        copyrightYear:2026
        foam stability index
        frail elderly
        frailty
        fried foods
        heart failure
        https://dx.doi.org/10.1093/ageing/afag031
        inLanguage:en
        mortality
        older adult
        older people
        patient prognosis
        phenotype
        physical functional performance
        prognosis
        publisher:Oxford University Press
        sameAs:https://pubmed.ncbi.nlm.nih.gov/41734100/
      ab: Background In older patients with heart failure, frailty assessment tools potentially have different prognostic value for all-cause mortality. Objective To compare the Frailty Screening Index (FSI), FRAIL scale and Fried phenotype. Design Post hoc analysis of the FRAGILE-HF study. Subjects Hospitalised patients (age ≥ 65 years) with heart failure. Methods We assessed frailty status at discharge, considered preadmission conditions of patients, using the FSI, FRAIL scale and Fried phenotype models and evaluated the primary outcome (2-year all-cause mortality), prognostic performance using Cox regression analysis (adjusted for the Meta-analysis Global Group in Chronic Heart Failure risk score and log-transformed B-type natriuretic peptide) and discriminative and reclassification abilities (area under the receiver-operating characteristic curve and continuous net reclassification improvement, respectively). Results Among 961 patients [median age: 80 (IQR, 74–85) years; 41.5% women], frailty was identified in 48.5%, 44.5% and 55.8% by the FSI, FRAIL scale and Fried models, respectively. During the 2-year follow-up, 187 (19.5%) patients died. On Kaplan–Meier analysis, frailty defined by the FRAIL and Fried was associated with significantly lower survival; FSI showed no significant difference. Adjusted Cox models showed that frailty was independently associated [HR (95% CI)] with mortality in FRAIL [1.31 (1.01–1.71)] and Fried [1.35 (1.04–1.75)] but not FSI [1.11 (0.84–1.37)]. The Fried model, incorporated into the baseline model, yielded the highest incremental prognostic value for 2-year all-cause mortality. Conclusions Frailty assessment using different tools yields varying results, with notable differences in their prognostic value for 2-year all-cause mortality. The frailty assessment tool influences both frailty classification and risk stratification and warrants careful clinical selection.
      pubtype: Academic Journal
      doctype: Article
      src: R
    language: English
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