The impact of frailty on the prognosis of chronic heart failure patients treated with cardiac resynchronization therapy defibrillator implantation
Objective The aim of this study was to assess the frailty status of patients with heart failure undergoing CRT-D and then explore the predictive value of frailty for all-cause mortality and heart failure-related readmissions in these patients.Methods We retrospectively included 374 patients with chronic heart failure who underwent CRT-D treatment at the First Affiliated Hospital of Xinjiang Medical University between June 2020 and June 2024.Based on the Tilburg Debilitation Assessment Scale,175 patients(46.8％)were classified as frail while 199(53.2％)were classified as non-frail.The baseline data between the two groups was compared using Cox regression analysis and Kaplan-Meier curves were used for survival analysis.P-values of＜0.05 indicated statistically significant differences.Results A total of 374 patients aged 25-93(68±11)years were enrolled in this study,101(27.0％)of which were female.Among these,175(46.8％)were categorized as frail,and 199(53.2％)were classified as non-frail.Over a median follow-up time of 23(5,45)months,35(9.4％)patients experienced all-cause mortality,with 30(17.1％)deaths occurring in the frail group and 5(2.5％)in the non-frail group;meanwhile,readmission events due to heart failure occurred in a total of 174(46.5％)patients,including 122(70.1％)in the frail group,and 52(29.9％)in the non-frail group.Cox analysis showed that frailty was a significant determinant of all-cause mortality(HR=21.25,95％CI 3.99-113.30,P＜0.001)and readmission among heart failure patients receiving CRT-D(HR=2.52,95％CI 1.73-3.68,P＜0.001).Log-rank tests showed that the survival rate of patients in the frail group was significantly lower than that of patients in the non-frail group(HR=7.22,95％CI 2.80-18.60,P＜0.001)and the risk of readmission events due to heart failure was significantly higher among patients in the frail group than among those in the non-frail group(HR=2.75,95％CI 1.98-3.81,P＜0.001).Conclusions Frailty is an independent predictor of postoperative all-cause mortality and the occurrence of heart failure-related readmissions in patients with heart failure treated receiving CRT-D.
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