Frailty as a risk factor for hospitalization and mortality in older adults admitted to a chronic heart failure hospital program before and during the COVID-19 pandemic

Objective: To determine whether frailty is a risk factor for hospitalization and mortality in older adults enrolled in the "Chronic Heart Failure Program" at a hospital in Lima, Peru, between 2018-2021. Methods: This was an ambispective cohort study. A total of 85 older adults participating in the Chronic Heart Failure Program at Guillermo Almenara National Hospital were included. Each had an initial frailty assessment, forming two cohorts: frail and non-frail older adults. Medical records were reviewed, and patients were followed for one year to track events of interest (hospitalization and mortality). Overall survival and risk factors for hospitalization and death were determined. Results: During follow-up, 15.3% of the older adults died, and frailty was identified in 58.8% of the patients. Overall survival using the Kaplan-Meier method was 96.5% at 3 months after entering the Chronic Heart Failure Program; 92.9% at 6 months; and 85.9% at one year. Multivariate analysis using Poisson regression found that frailty was not a risk factor for hospitalization (aRR = 0.92; 95% CI: 0.42-2.03). Survival analysis using the Cox proportional hazards model showed that frailty was also not a risk factor for mortality after one year of follow-up (aHR = 1.32; 95% CI: 0.27-6.53). Conclusions: Our research does not confirm frailty as a risk factor for hospitalization or mortality in older adults enrolled in the "Chronic Heart Failure Program" after one year of follow-up.