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Backgrounds <p>The optimal multidimensional frailty assessment approach in heart failure (HF) remains uncertain. This study aimed to compare the prognostic value of a multi-domain approach versus the Tilburg Frailty Indicator (TFI) in elderly HF patients.</p> Methods <p>This prospective single-center cohort study consecutively enrolled 461 elderly HF patients at Fuzhou University Affiliated Provincial Hospital, China. Frailty was assessed using both the TFI and a multi-domain approach. The primary outcome was the composite of heart failure hospitalization or all-cause death within six months. Clinical outcomes were analyzed using Kaplan-Meier and Cox proportional hazards regression models, with predictive performance compared by receiver operating characteristic curves.</p> Results <p>Among 461 participants, physical, psychological, and social frailty prevalence rates were 41.0%, 59.9%, and 56.8%, respectively. Multidimensional frailty, assessed by the TFI, was present in 77.4% of the cohort. The risk of composite outcome increased significantly with the number of frailty domains [2 domains: adjusted HR = 1.74 (95% CI: 1.08–2.79); 3 domains: HR = 2.07 (1.28–3.35)]. TFI-based analysis yielded consistent results. Notably, the predictive accuracy of frailty domains (area under the curve (AUC) = 0.63, 95% CI: 0.58–0.69) did not significantly differ from that of the TFI (AUC = 0.64, 95% CI: 0.59–0.70; <i>P</i> = 0.713), indicating comparable discriminative ability.</p> Conclusions <p>In elderly HF patients, both the multi-domain frailty assessment and the TFI demonstrated comparable predictive value for heart failure hospitalization or all-cause death within six months.</p>

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Prognostic impact of multi-domain approaches and the Tilburg frailty indicator in elderly patients with heart failure

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年7月19日

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  • Xiaodan Guo,
  • Minmin Wu,
  • Huazhen Xiao,
  • Jialin Liu,
  • Xiaoqian Zhu,
  • Shuang Jin,
  • Yuhong Liu,
  • Yuanfan Zhu,
  • Xin Lin,
  • Yan Mu

摘要

Backgrounds

The optimal multidimensional frailty assessment approach in heart failure (HF) remains uncertain. This study aimed to compare the prognostic value of a multi-domain approach versus the Tilburg Frailty Indicator (TFI) in elderly HF patients.

Methods

This prospective single-center cohort study consecutively enrolled 461 elderly HF patients at Fuzhou University Affiliated Provincial Hospital, China. Frailty was assessed using both the TFI and a multi-domain approach. The primary outcome was the composite of heart failure hospitalization or all-cause death within six months. Clinical outcomes were analyzed using Kaplan-Meier and Cox proportional hazards regression models, with predictive performance compared by receiver operating characteristic curves.

Results

Among 461 participants, physical, psychological, and social frailty prevalence rates were 41.0%, 59.9%, and 56.8%, respectively. Multidimensional frailty, assessed by the TFI, was present in 77.4% of the cohort. The risk of composite outcome increased significantly with the number of frailty domains [2 domains: adjusted HR = 1.74 (95% CI: 1.08–2.79); 3 domains: HR = 2.07 (1.28–3.35)]. TFI-based analysis yielded consistent results. Notably, the predictive accuracy of frailty domains (area under the curve (AUC) = 0.63, 95% CI: 0.58–0.69) did not significantly differ from that of the TFI (AUC = 0.64, 95% CI: 0.59–0.70; P = 0.713), indicating comparable discriminative ability.

Conclusions

In elderly HF patients, both the multi-domain frailty assessment and the TFI demonstrated comparable predictive value for heart failure hospitalization or all-cause death within six months.