Frailty scale predicts mortality in HF patients

The Clinical Frailty Scale (CFS) can independently predict mortality at 2 years in patients with heart failure (HF), suggests a study.

“Frailty is prevalent in patients with HF and is associated with adverse outcomes,” the authors said. “However, the extent to which the CFS accurately captures physical and cognitive decline and its prognostic utility in contemporary HF care remain uncertain.”

To address this, 3,905 hospitalized patients with HF from a prospective, nationwide, multicentre registry were included in this study and stratified into categories (1‒2, 3, 4, 5, 6, and 7‒9) according to the CFS.

The authors assessed physical function using gait speed, the 5-chair stand test, the Short Physical Performance Battery (SPPB), grip strength, and 6-min walk distance. They also evaluated cognitive function using the Mini-Cog test. The primary outcome was 2-year all-cause mortality after discharge.

Increasing CFS severity correlated with a progressive decline in physical function metrics and Mini-Cog scores. Of the patients with HF, 725 (18.6 percent) died over 2 years of follow-up, with mortality increasing stepwise with higher CFS scores.

Notably, the addition of CFS to the prognostic model led to a significant improvement in discrimination relative to a model based on the SPPB and Mini-Cog test.

The CFS is “a robust integrative measure of physical and cognitive vulnerability in patients with HF … providing a practical screening tool that complements formal performance-based frailty assessments in contemporary HF management,” the authors said.