Illness burden’s link to death is weaker with frailty in heart failure
High versus low illness burden was linked to 42% higher relative death risk in non-frail heart failure patients, versus 13% in frail patients.
Limit: Findings differed among females and patients with HFpEF
Edited by Boris Djordjevic · AgingResearch.News
A retrospective cohort study of 18,058 people with heart failure examined whether illness counts had different links to death depending on frailty. Their median age was 74, and 62% were male. Researchers assessed frailty, a state of reduced physical reserves, using measures of function, nutrition and body chemistry. They classified 64% as frail and counted illnesses from a list of 26 conditions.
Over a median follow-up of 4.0 years, 57% died. Frailty was associated with a 91% higher relative risk of death after adjustment for other factors. Compared with low illness burden, intermediate burden was linked to an 18% higher relative risk in non-frail patients, but no excess risk in frail patients. High burden was linked to 42% higher relative risk in non-frail patients and 13% in frail patients.
Why it matters
For older people with heart failure, estimating risk may require considering physical reserves as well as the number of illnesses.
Caveats
This observational study could not establish cause and effect. The conference abstract reported differing results in women and one heart failure subtype, without detailing those differences.
The paper
Frailty redefines the prognostic value of multimorbidity in heart failure