Frailty index as a prognostic factor in patients with decompensated heart failure

• Grant number: 24/16608-2
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: November 01, 2024
• End date: October 31, 2025
• Field of knowledge: Health Sciences - Medicine - Medical Clinics
• Principal Investigator: Silvia Moreira Ayub Ferreira
• Grantee: Blas Ivan Ferreira Ayala
• Host Institution: Instituto do Coração Professor Euryclides de Jesus Zerbini (INCOR). Hospital das Clínicas da Faculdade de Medicina da USP (HCFMUSP). Secretaria da Saúde (São Paulo - Estado). São Paulo , SP, Brazil

Abstract

1. IntroductionFrailty is a syndrome characterized by a decrease in functional reserve, making the body less resistant to acute stress events, which leads to prolonged hospitalizations, worse prognosis, and lower survival rates. In Brazil, there are around 2 million people with heart failure, with 240,000 new cases annually. It is estimated that half of these patients are frail. Decompensated heart failure accounts for 60% of treatment costs, making it essential to assess the frailty status of these patients, especially those requiring surgery. The Clinical Frailty Scale (CFS) is a useful method to diagnose frailty in hospitalized patients, providing a quick assessment based on a questionnaire.2. ObjectivesThe study aims to understand the impact of frailty in patients under 70 years of age with decompensated heart failure. Three factors are evaluated: 3-month mortality rate, 3-month involuntary readmission rate, and length of hospital stay. Laboratory parameters such as liver and kidney function, albumin, and B-type natriuretic peptide (BNP) are also analyzed for correlation with the degree of frailty.3. Methodology3.1 Study DesignThe study includes patients hospitalized with decompensated heart failure/cardiogenic shock. Frailty status is assessed using the CFS, which classifies the patient into 9 categories ranging from "Very Fit" to "Terminally Ill." The evaluation is based on a questionnaire about the patient's daily activities and overall health, considering their condition in the two weeks prior to hospitalization.After 90 days, data are collected from medical records or through contact with patients or family members. The factors analyzed include mortality, readmission, and length of stay, along with laboratory tests.3.2 Inclusion CriteriaPatients between 18 and 70 years old diagnosed with decompensated heart failure, who consented via the Informed Consent Form (ICF).3.3 Exclusion CriteriaPatients over 70 years old or unable to consent, or those without a clinical diagnosis of decompensated heart failure.4. Benefits and RisksBenefits include a better understanding of the effects of frailty on cardiac patients, allowing for more accurate assessment and proper allocation of healthcare resources. The risks are minimal, mainly related to the privacy of patient information.5. TimelineThe study follows a data collection phase lasting 9 months, followed by 3 months of analysis and publication of results.6. BudgetThe estimated cost is R$ 30.00 for document printing.