Utility of the Vulnerable Elders Survey-13(VES-13)in detect-ing frailty and predicting prognosis in heart failure outpati-ents
Thaïs Roig1
Elisabet Zamora2
Josep Lupón2
Beatriz González3
Ana Pulido3
Eva Crespo3
Patricia Velayos3
Carmen Rivas3
Violeta Díaz3
Yolanda López4
Andrea Borrel-las3
Mar Domingo5
María Ruiz3
Pau Codina3
Evelyn Santiago-Vacas3
Miquel À Mas6
Ramón Miralles6
Antoni Bayes-Genis2
1.Department of Geriatric Medicine,University Hospital Germans Trias i Pujol,Badalona,Spain;Heart Failure Unit,Department of Cardiology,University Hospital Germans Trias i Pujol,Badalona,Spain;Department of Medicine,Uni-versitat Autònoma de Barcelona,Spain2.Heart Failure Unit,Department of Cardiology,University Hospital Germans Trias i Pujol,Badalona,Spain;Department of Medicine,Uni-versitat Autònoma de Barcelona,Spain;CIBER Cardiovascular,Health Institute Carlos Ⅲ,Madrid,Spain3.Heart Failure Unit,Department of Cardiology,University Hospital Germans Trias i Pujol,Badalona,Spain4.Department of Geriatric Medicine,University Hospital Germans Trias i Pujol,Badalona,Spain5.Heart Failure Unit,Department of Cardiology,University Hospital Germans Trias i Pujol,Badalona,Spain;CIBER Cardiovascular,Health Institute Carlos Ⅲ,Madrid,Spain6.Department of Geriatric Medicine,University Hospital Germans Trias i Pujol,Badalona,Spain;Department of Medicine,Uni-versitat Autònoma de Barcelona,Spain
摘要：Background Frailty is common and significantly impacts prognosis in heart failure(HF).The Vulnerable Elders Survey-13(VES-13),widely used in oncogeriatrics and public health,remains unexplored as a frailty screening tool in HF outpatients.In this study,we prospectively evaluated VES-13 against a multimodal screening assessment in detecting frailty and predicting indi-vidual risk of adverse prognosis.
Methods Frailty was assessed at the initial visit using both a multimodal approach,incorporating Barthel Index,Older Americ-an Resources and Services scale,Pfeiffer Test,abbreviated Geriatric Depression Scale,age>85 years,lacking support systems,and VES-13.Patients scoring≥3 on VES-13 or meeting at least one multimodal criterion were classified as frail.Endpoints in-cluded all-cause mortality,a composite of death or HF hospitalization,and recurrent HF hospitalizations.
Results A total of 301 patients were evaluated.VES-13 identified 40.2%as frail and the multimodal assessment 33.2%.In Cox regression analyses,frailty identified by VES-13 showed greater prognostic significance than the multimodal assessment for all-cause mortality(HR=3.70[2.15-6.33],P<0.001 vs.2.40[1.46-4.0],P=0.001)and the composite endpoint(HR=3.13[2.02-4.84],P<0.001 vs.1.96[1.28-2.99],P=0.002).Recurrent HF hospitalizations were four times more frequent in VES-13 frail patients while two times in those identified as frail by the multimodal assessment.Additionally,stratifying patients by VES-13 tertiles provided robust risk differentiation.
Conclusions VES-13,a simple frailty tool,outperformed a comprehensive multimodal assessment and could be easily integ-rated into routine HF care,highlighting its clinical utility in identifying patients at risk for poor outcomes.
机标关键词：prognosisutilityheartdetect-ingeldersfailurefrailtyoutpati-ents
论文发表日期：2026-01-30
在线出版日期：2026-03-16（本平台首次上网日期，不代表文献的发表时间）
页数：10( 17-26 )