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 The leading web portal for pharmacy resources, news, education and careers December 15, 2018
Pharmacy Choice - Pharmaceutical News - AMDA: Study Suggests Frailty As a Predictor of Readmission and Mortality in Heart Failure - December 15, 2018

Pharmacy News Article

 11/16/18 - AMDA: Study Suggests Frailty As a Predictor of Readmission and Mortality in Heart Failure

COLUMBIA, Maryland, Nov. 15 AMDA - The Society for Post-Acute and Long-Term Care Medicine issued the following news release:

Frailty in the elderly has long been associated with an increased risk of falls, functional limitations, hospitalizations, and death. Now a new study in the November issue of JAMDA shows frailty as a significant predictor of all-cause mortality and hospital readmissions in patients with heart failure.

In "Frailty and Clinical Outcomes in Heart Failure: A Systematic Review and Meta-analysis," the authors analyzed studies in the PubMed and Embase databases that involved patients with a definite diagnosis of heart failure and frailty that was quantified and related to the primary endpoints of all-cause mortality or hospitalization. The analysis demonstrated a 1.59-fold increase in the risk of all-cause mortality for frail patients, compared with non-frail patients. Additionally, they observed a significantly higher risk of hospital readmissions between the frail and non-frail patients. The study also suggested that patients with frailty, compared to non-frail patients, had a significantly increased risk of all-cause mortality after undergoing ventricular assist device (VAD) implantation.

The authors noted that frailty has an estimated prevalence of 44.5% in heart failure and thus may be a critical factor in influencing outcomes in this population. The question of why frailty has a negative impact on clinical outcomes in heart failure, the authors said, "can be appreciated from preclinical, clinical, and meta-analytical studies." Frailty and prefrailty, they indicated, are associated with higher levels of oxidative stress and reduced antioxidant abilities, as well as significantly higher pro-inflammatory activities. They suggested that frailty is also related to comorbid conditions such as hypertension and atrial fibrillation, which can increase the risk of stroke.

Clinicians who actively seek to identify patients with frailty, the authors said, can intervene by promoting physical activity, offering nutrition and vitamin supplements, and reducing polypharmacy. They added that palliative care to treat frailty might improve prognosis. The authors further suggested that frailty assessment can aid risk stratification by identifying those who may benefit most from invasive management and interventions such as VAD implantation. Finally, they said, previous cost analyses "revealed that frailty was associated with a significant increase in hospitalization costs after cardiac surgery."

The study was conducted by researchers at the Department of Cardiology, Tianjin Institute of Cardiology; Second Hospital of Tianjin Medical University, Tianjin, RP China; and the Li Ka Shing Institute of Health Sciences, Faculty of Medicine, Chinese University of Hong Kong, SAR, PR China.

© 2018 Targeted News Service

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