Multimorbidity frailty index and clinical outcomes among 42,989 older heart failure patients directly discharged from emergency departments: A nationwide retrospective cohort study
Year: 2025
Type: article
Study design: Observational Study
Abstract: AIMS: Frailty, a common and clinically significant condition in older adults with heart failure (HF), is often overlooked in emergency department (ED) settings. This study aims to evaluate the impact of frailty on clinical outcomes in older adults directly discharged from the ED due to HF. METHODS AND RESULTS: This retrospective cohort study used data from Taiwan's National Health Insurance (NHI) database, identifying older adults (≥65 years) discharged from the ED due to HF between 2017 and 2021. Frailty was assessed using a 38-item multimorbidity frailty index (mFI) derived from ICD-10-CM codes, stratifying patients into fit, mild-to-moderately frail, and severely frail. Outcomes included all-cause mortality, all-cause readmissions, and HF-related readmissions. Cox regression and Fine and Gray models estimated the impact of frailty on these outcomes. Among 42,989 older HF patients (mean age 80.7 ± 8.2 years, 55.5 % female), 57.8 % were frail (46.4 % mild-to-moderately frail and 11.4 % severely frail). Six-month mortality rates were 12.0 % in fit, 16.0 % in mild-to-moderately frail, and 19.4 % in severely frail patients. Readmission rates showed similar patterns. The severely frail group had higher risks of mortality (aHR 1.44, 95 % CI 1.33-1.55), all-cause readmissions (sHR 1.69, 95 % CI 1.62-1.76), and HF-related readmissions (sHR 1.59, 95 % CI 1.48-1.71). CONCLUSION: Frailty is prevalent among older adults directly discharged from the ED due to HF and significantly elevates risks of mortality and readmissions. These findings highlight the need for frailty assessment in ED settings for older HF patients to optimize care planning, and improve outcomes.
Source: Experimental Gerontology
Authors: Wan-Ju Liao, Hsi-Yu Lai, Liang-Yi Lin, Cheng-Hsueh Wu, Fei-Yuan Hsiao, Liang-Kung Chen
Language: English
Topic: Frailty in Older Adults
Subfield: Geriatrics and Gerontology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,400
Awards: Brain Aging: Muscle-To-Brain Axis Modulates Physio-Cognitive Decline( II ), G2890557184, Constructing Healthy Living in Super-Aged Society by Artificial Intelligence: from Geroprotective Intervention to Care Management( Iv ), Constructing Predictive Analytics for Healthy Longevity and Degenerative Disorders Using Multimodal Big Data( I ), Biosignature of Physio-Cognitive Decline Syndrome: towards Precision Healthy Aging( II )
OpenAlex ID: W4409413184