Kałużna-Oleksy Marta, Kukfisz Agata, Migaj Jacek, Dudek Magdalena, Krysztofiak Helena, Sawczak Filip, Szczechla Magdalena, Przytarska Katarzyna, Straburzyńska-Migaj Ewa, Wleklik Marta, Uchmanowicz Izabella
1st Department of Cardiology, Poznań University of Medical Sciences, 61-848 Poznań, Poland.
Lord's Transfiguration Clinical Hospital, Poznań University of Medical Sciences, 61-848 Poznan, Poland.
J Clin Med. 2021 Dec 19;10(24):5963. doi: 10.3390/jcm10245963.
Frailty syndrome (FS) has recently attracted attention as one of the major predictors of heart failure (HF) course severity. We aimed to develop a simple tool for predicting frailty in hospitalized HF patients using routine clinical parameters. A total of 153 hospitalized patients diagnosed with heart failure with reduced ejection fraction (HFrEF) were included in the study. Presence of FS was assessed with the SHARE-FI questionnaire. Clinical and biochemical parameters were collected. Using ROC curves and logistic regression analysis, a model predicting FS presence was developed and tested. Proposed model includes five variables with following cut-off values (1 point for each variable): age > 50 years, systolic pressure on admission < 110 mmHg, total cholesterol < 4.85 mmol/L, bilirubin ≥ 15.5 mmol/L, and alanine aminotransferase ≤ 34 U/L. Receiving 5 points was considered a high risk of FS with positive and negative predictive values (NPV), 83% and 72%, respectively, and specificity of 97%. Awarding 2 points or less ruled out FS in the studied group with negative predictive value 94%. The presented novel, simple score predicts FS in HFrEF patients with routine clinical parameters and has good positive and negative predictive values.
衰弱综合征(FS)作为心力衰竭(HF)病程严重程度的主要预测因素之一,最近受到了关注。我们旨在利用常规临床参数开发一种简单的工具,用于预测住院HF患者的衰弱情况。本研究共纳入了153例诊断为射血分数降低的心力衰竭(HFrEF)的住院患者。采用SHARE - FI问卷评估FS的存在情况。收集临床和生化参数。通过ROC曲线和逻辑回归分析,开发并测试了一个预测FS存在的模型。所提出的模型包括五个变量及其截断值(每个变量1分):年龄>50岁、入院时收缩压<110 mmHg、总胆固醇<4.85 mmol/L、胆红素≥15.5 mmol/L和丙氨酸转氨酶≤34 U/L。得5分被认为是FS的高风险,阳性预测值(PPV)和阴性预测值(NPV)分别为83%和72%,特异性为97%。在研究组中,得2分或以下可排除FS,阴性预测值为94%。所提出的新颖、简单的评分方法利用常规临床参数预测HFrEF患者的FS,具有良好的阳性和阴性预测值。