Survival of Frail Older Adults with Cardiovascular Disease After 365 Days Post-Hospital Discharge

Background/Objectives: Frailty in older adults with cardiovascular disease is associated with higher morbidity, hospitalization, and mortality, but other relevant outcomes also exist. Therefore, this study aimed to analyze the relationship between frailty and survival in hospitalized older adults with cardiovascular disease, considering post-discharge events over the following 365 days, including received healthcare and mortality. Methods: Observational study involving patients aged ≥60 years admitted to cardiology between March 2022 and April 2024. Frailty was assessed using the FRAIL scale (frail, pre-frail, robust). Clinical variables included: Barthel Index, body mass index, abdominal circumference, diabetes mellitus, hemoglobin, albumin, creatinine, previous readmissions, and hospital stay. Follow-up at 365 days post-discharge evaluated time to first cardiology visit, first medical visit for other reasons, emergency care, unplanned readmission, and death, using Kaplan-Meier curves, Log-rank test, and Cox regression (95% CI, p-value = 0.05). Results: 130 patients were included (male: 68.46%, female: 31.54%; mean age: 72.98 ± 7.67 years). 35.38% were frail, with a longer average hospital stay (p=0.040). Barthel scores were higher in robust patients (p=0.003). Frail patients required faster consultations and admissions: cardiology (HR: 1.565; 95%CI: 1.016–2.409; p=0.042); other reasons (HR: 1.709; 95%CI: 1.125–2.596; p=0.012); and unplanned readmissions (HR: 2.109; 95%CI: 1.076–4.135; p=0.030). Hemoglobin and total cholesterol were predictive factors for the first cardiology visit (HR=0.808; 95%CI=0.686–0.952; p=0.011; HR=0.980; 95%CI=0.961–0.999; p=0.037). In multivariate analysis, frailty independently predicted non-cardiac consultations (HR = 2.329; 95% CI: 1.163–4.664; p = 0.017). Conclusions: Frailty assessed by the FRAIL scale moderately predicts post-discharge healthcare utilization. Frail patients showed reduced survival. Systematic frailty assessment and the combined use of functional and analytical factors may improve the management and follow-up of frail and pre-frail patients.