title: Prognostic implication of frailty and depressive symptoms in an outpatient population with heart failure.
abstract: OBJECTIVE
  Heart failure patients have high levels of frailty and dependence. Our aim was to determine the impact of frailty and depressive symptoms on the 1-year mortality rate and the rate of hospitalization for heart failure during a follow-up period of 1 year.
  
  
  METHODS
  All patients underwent geriatric evaluation, and frailty and depressive symptoms were identified. The study included 622 patients (72.5% male; median age, 68 years; 92% in New York Heart Association class II or III; and median ejection fraction, 30%).
  
  
  RESULTS
  During follow-up, 60 patients (9.5%) died and 101 (16.2%) were hospitalized for heart failure. Overall, 39.9% of patients exhibited frailty, while 25.2% had depressive symptoms. There were significant associations between mortality at 1 year and the presence of frailty (16.9% vs. 4.8%; P< .001) and depressive symptoms (15.3% vs. 7.7%; P=.006). There was also a significant relationship between heart failure hospitalization and the presence of frailty (20.5% vs. 13.3%; P=.01). No relationship was found between heart failure hospitalization and depressive symptoms. Frailty was an independent predictor of mortality but not of hospitalization.
  
  
  CONCLUSIONS
  Univariate analysis demonstrated significant relationships between frailty and depressive symptoms and mortality at 1 year. In addition, there was a significant relationship between frailty and the need for heart failure hospitalization. However, only frailty showed prognostic value to predict mortality, which was independent of other variables strongly associated to outcome.
authors.affiliation: Unitat d'Insuficiència Cardíaca, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain. jlupon.germanstrias@gencat.cat
authors.forename: Josep
authors.initials: J
authors.lastname: Lupón
authors.forename: Beatriz
authors.initials: B
authors.lastname: González
authors.forename: Sebastián
authors.initials: S
authors.lastname: Santaeugenia
authors.forename: Salvador
authors.initials: S
authors.lastname: Altimir
authors.forename: Agustín
authors.initials: A
authors.lastname: Urrutia
authors.forename: Dolores
authors.initials: D
authors.lastname: Más
authors.forename: Crisanto
authors.initials: C
authors.lastname: Díez
authors.forename: Teresa
authors.initials: T
authors.lastname: Pascual
authors.forename: Lucía
authors.initials: L
authors.lastname: Cano
authors.forename: Vicente
authors.initials: V
authors.lastname: Valle
mesh_terms: D000368:Aged; D003863:Depression / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D016330:Frail Elderly; D015577:Geriatric Assessment; D006333:Heart Failure / Q000150:complications / Q000401:mortality*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D010045:Outpatients; D011379:Prognosis; D013997:Time Factors