Conectar
This study aimed to identify the heterogeneous trajectories of frailty and determine the predictors of distinct trajectories in patients with heart failure.
A longitudinal study.
A total of 253 patients with heart failure were recruited at the cardiology department of a tertiary hospital between February and December 2023. Frailty was assessed at baseline, 1 and 4 months after discharge. Patients' sociodemographic characteristics, physical symptoms, nutritional status, psychological distress, illness perception and social networks were obtained at baseline using a structured questionnaire. Group-based trajectory modelling was performed to identify the heterogeneity of the trajectories of frailty. Multiple logistic regression and decision tree models were used to explore the predictors of heterogeneous trajectories of frailty.
Three distinct trajectories of frailty were identified in patients with heart failure: low frailty with high-degree improvement group (46.2%), moderate frailty with high-degree improvement group (41.1%) and high frailty with low-degree improvement group (12.6%). Multiple logistic regression analysis showed that physical symptoms, nutritional status, illness perception and employment status were entered as independent predictors of heterogeneous trajectories of frailty. The decision tree model demonstrated that physical symptoms were the primary predictors, followed by nutritional status, illness perception and psychological distress.
Three distinct categories of frailty trajectories were identified in patients with heart failure. Physical symptoms, nutritional status, psychological distress, illness perception and employment status were independent predictors of heterogeneous trajectories of frailty, with physical symptoms being the most important predictor.
Dynamic frailty assessment is recommended. Interventions aimed at alleviating physical symptoms, psychological distress and negative illness perception, and improving nutritional status may be conducive to delaying or reversing frailty in patients with heart failure, particularly in unemployed individuals.
The reporting followed the STROBE guideline.
No patient or public contribution.
Weight management is an important part of disease management in patients with heart failure. However, the effectiveness of reported weight management interventions is inconclusive.
The aim of this systematic review and meta-analysis was to assess the effects of weight management on functional status, heart failure-related hospitalizations, and all-cause mortality in patients with heart failure.
PubMed, Web of Science, Embase, and the Cochrane Library were searched on April 3, 2022. This study was registered with PROSPERO (CRD42021283817). Eligible studies assessed functional status, heart failure-related hospitalizations, and all-cause mortality in patients with heart failure. Two researchers independently screened the articles, extracted data, and evaluated the risk bias of each study. Dichotomous variables were presented as OR with a 95% confidence interval (CI). The data were analyzed using a fixed effect or random effect model, and heterogeneity was determined using I 2 statistics. All statistical analyses were conducted using RevMan 5.3.
Among 4279 studies screened, seven randomized controlled trials were included in this study. The results showed that weight management significantly improved functional status (OR = 0.15, 95% CI [0.07, 0.35], I 2 = 52%) and reduced the risk of all-cause mortality (OR = 0.54, 95% CI [0.34, 0.85], I 2 = 0%), but had no significant effect on heart failure-related hospitalizations (OR = 0.72, 95% CI [0.20, 2.66]).
Weight management has effects on improved functional status and reduced all-cause mortality in patients with heart failure. It is necessary to strengthen the weight management interventions of patients with heart failure to improve patients' functional status and reduce all-cause mortality.
FreshRSS