GIÁ TRỊ TIÊN LƯỢNG CỦA THANG ĐIỂM SUY YẾU LÂM SÀNG (CLINICAL FRAILTY SCALE) ĐỐI VỚI CÁC BIẾN CỐ TIM MẠCH CHÍNH TRONG 6 THÁNG Ở BỆNH NHÂN SUY TIM CẤP CAO TUỔI

Abstract

Objectives: To evaluate the association between CFS‑defined frailty and 6‑month major cardiovascular events in elderly AHF patients. Results: Mean age was 72.9 ± 8.8 years; 57.5% were men; 53.3% were frail (CFS ≥ 5). At 6 months, cardiovascular death occurred in 19.2%, heart‑failure rehospitalization in 33.8%, and the composite endpoint in 52.9%. Frail patients had markedly higher rates of composite events (67.2% vs. 36.6%) and cardiovascular death (33.6% vs. 2.7%; both p < 0.001), while heart‑failure rehospitalization was similar between groups. In multivariable Cox models, each 1‑point increase in CFS independently increased the risk of the composite endpoint (HR 1.77; 95% CI 1.45–2.17), cardiovascular death (HR 2.39; 95% CI 1.80–3.19) and rehospitalization (HR 1.41; 95% CI 1.09–1.82). CFS showed fair discrimination for the composite endpoint (AUC 0.703) and good discrimination for cardiovascular death (AUC 0.836) at CFS ≥ 5, but no discrimination for rehospitalization (AUC 0.493). Conclusions: Frailty assessed by CFS is highly prevalent and is an independent and powerful predictor of 6‑month cardiovascular death and composite events in elderly AHF patients. A cutoff CFS ≥ 5 identifies a high‑risk group, whereas CFS alone is insufficient to predict heart‑failure rehospitalization.