Prognostic implication of frailty and depressive symptoms in an outpatient population with heart failure.
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.
Lupón
Josep
J
Unitat d'Insuficiència Cardíaca, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain. jlupon.germanstrias@gencat.cat
González
Beatriz
B
Santaeugenia
Sebastián
S
Altimir
Salvador
S
Urrutia
Agustín
A
Más
Dolores
D
Díez
Crisanto
C
Pascual
Teresa
T
Cano
Lucía
L
Valle
Vicente
V
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