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Rising time predicts frailty at discharge in elderly heart failure patients

07 Jun 2020

In elderly patients with acute heart failure (HF), rising time from bed in the first 2 days after admission appears to be indicative of frailty upon discharge, a recent study has found.

Researchers performed a retrospective cohort study of 387 consecutive older patients (mean age, 74.9±6.1 years; 63.6 percent male) with HF. Rising time was measured within 2 days after admission, in line with cardiac rehabilitation initiation. At discharge, a frailty score was assigned based on four domains: gait speed, handgrip strength, serum albumin, and activities of daily living.

The median frailty score was 5, with 53.5 percent of participants falling at or above this threshold and being designated as frail. They tended to be older than non-frail counterparts. The median rising time was 6.8 seconds.

Logistic regression analysis, adjusted for potential covariates, found that rising time was a significant and independent predictor of frailty (odds ratio [OR], 1.10, 95 percent confidence interval [CI], 1.04–1.18; p=0.023). This remained true in subgroups of patients with or without prior HF or diabetes.

Youden index identified an optimal cutoff value of 7.1 seconds for the identification of participants at risk of frailty upon discharge. The resulting area under the receiver operating characteristic curve was 0.71 (95 percent CI, 0.66–0.76).

“These results will be useful for risk stratification. The assessment of rising time is a convenient, rapid, and secure method that can be measured using only a stopwatch and does not require training,” said researchers.

“This assessment should be added to the standard cardiac rehabilitation for elderly patients with HF to predict frailty and for rehabilitation planning,” they added.

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