Prevalence and Risk Factors Associated with Frailty Syndrome in Chronic Heart Failure Patients at Heart Failure Clinic at Vajira Hospital Prevalence and Risk Factors Associated with Frailty Syndrome in Chronic HF Patients

Abstract

OBJECTIVE: The prevalence of frailty syndrome in patients with chronic heart failure (HF) at Vajira Hospital was investigated, and risk factors associated with frailty syndrome and chronic HF were identified for optimizing management and improving outcomes in this vulnerable population.
METHODS: A prospective cross-sectional study was conducted at chronic HF clinic of Vajira Hospital by history taking, collecting data with questionnaires, and performing specific tests (Fried Frailty Phenotype). Echocardiogram and N-terminal pro-B-type natriuretic peptide (NT-proBNP) were obtained from chronic HF patients from January 2022 to December 2023. A physician collected clinical data and baseline characteristics. All patients were tested for the Fried Frailty Phenotype by a physical therapist. Determinants were evaluated using univariate and multivariate logistic regression models.
RESULTS: A total of 94 patients were enrolled. The prevalence of frailty syndrome in patients with HF was 27.70% (95% CI: 18.90–37.80). Univariate analysis showed that factors associated with increased likelihood of frailty syndrome in patients with chronic HF included chronic kidney disease (CKD stages IV–V, unadjusted OR = 4.00, 95% CI: 1.11–14.43, p-value = 0.03), New York Heart Association (NYHA; III–IV, unadjusted OR = 39.00, 95% CI: 8.30–183.29, p-value < 0.001), left ventricular ejection fraction (≤ 40%, unadjusted OR = 3.84, 95% CI: 1.13–13.02, p-value = 0.031), NT-proBNP (> 1000 pg/mL, unadjusted OR = 5.50, 95% CI: 1.71–17.66, p-value = 0.004) and diuretics (unadjusted OR = 8.33, 95% CI: 1.05–66.22, p-value = 0.045) but multivariate analysis showed only NYHA (III-IV), adjusted OR = 30.51, 95% CI: 6.01–154.94, p-value < 0.001) increase risk of frailty syndrome.
CONCLUSION: The prevalence of frailty syndrome in patients with chronic HF was found, and the main associated factor affecting frailty is NYHA(III-IV). NYHA classification and frailty in HF patients are crucial for comprehensive management. Regular assessment of NYHA class, frailty status, and associated factors (physical, cognitive, nutritional, and psychosocial) is essential for personalized care planning.