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Aims To compare the frailty prevalence and predictive performance of six frailty instruments in adults with heart failure and determine the feasibility of study methods. Methods and results Prospective cohort pilot study. Adults aged 18 years or older with a confirmed diagnosis of heart failure in Sydney, New South Wales, Australia. The Frailty Phenotype; the Survey of Health, Ageing, and Retirement in Europe Frailty Instrument (SHARE-FI); St Vincent's Frailty instrument; St Vincent's Frailty instrument plus cognition and mood; The Fatigue, Resistance, Ambulation, Illnesses, and Loss of Weight (FRAIL) scale; and the Deficit Accumulation Index (DAI) were compared. Multiple logistic regression was used to develop six frailty instrument models to evaluate the association between each frailty instrument and composite all-cause rehospitalization and mortality at 12 months. One hundred and thirty-one patients were included with a mean age of 54 [± 14(SD)]. Frailty prevalence ranged from 33 to 81%. All instruments except one (the FRAIL scale) appeared to signal an increased odds of rehospitalization and/or mortality, yet these results were non-significant. The six frailty instrument models displayed sensitivity between 88–92% and C-statistic values of 0.71–0.73, suggesting satisfactory discrimination. Conclusion The prevalence of frailty varied across six frailty instruments yet was in the higher range despite a 'younger' heart failure cohort. Further research is required to confirm the psychometric properties of these instruments for routine clinical use in an adequately powered and more diverse heart failure cohort. [ABSTRACT FROM AUTHOR]

Background: Frailty is an important predictive measure of mortality and rehospitalisation in people with heart failure. To date, there are no frailty instruments validated for use in people with heart failure. Aim: The aim of this study was to evaluate the convergent and discriminant validity of three versions of the frailty phenotype in those with heart failure. Methods: A single site, prospective cohort study was undertaken among individuals with a confirmed diagnosis of heart failure. Frailty was assessed concurrently using three versions of the frailty phenotype: the original frailty phenotype and two modified versions; the Survey of Health, Ageing and Retirement in Europe frailty instrument (SHARE-FI) and the St Vincent's frailty instrument. Convergent and discriminant validity were assessed by reporting the correlations between each version and related heart failure subconstructs, and by evaluating the ability of each version to discriminate between normal and abnormal scores of other physical and psychosocial scales specific to heart failure-related subconstructs. Results: The New York Heart Association classes were moderately correlated with the St Vincent's frailty instrument (r =0.47, P ⩽0.001), SHARE-FI (r =0.42, P ⩽0.001) and the frailty phenotype (r =0.42, P ⩽0.001). The SHARE-FI and the St Vincent's frailty instrument were both able to discriminate consistently between normal and abnormal scores in three out of five of the physical and psychosocial subconstructs that were assessed. The SHARE-FI was also able to discriminate between inpatients and outpatients who were classified as frail. Conclusions: Both the SHARE-FI and the St Vincent's frailty instrument displayed good convergent and discriminant validity. [ABSTRACT FROM AUTHOR]

ABSTRACT Aims Design Methods Results Conclusions Implications for the Profession and/or Patient Care Impact Reporting Method Patient or Public Contribution To compare contextual factors influencing discharge practices in three intensive care units (ICUs).A prospective observational study.Data were collected using a discharge process report form (DPRF) between May and September 2023. Descriptive statistics were performed to analyse demographic and clinical data. One‐way analysis of variance (ANOVA) was used to test the time interval differences among the three sites.Overall, 69 patients' discharge processes were observed. Among them, 41 (59%) experienced discharge delay, and 1 in 5 patients experienced after‐hours discharge. There were statistically significant differences in mean hours in various time intervals during the discharge processes among the three sites. Patients in Hospital C waited the longest time (mean = 31.9 h) for the ward bed to be ready after the bed was requested and for being eventually discharged after ICU nurses to get them ready for discharge (mean = 26.7 h) compared to Hospital A and Hospital B.We found that discharge delay and after‐hours discharge were common and there were significant differences in mean hours of various time intervals during the discharge processes occurred among the three sites. The influence of contextual factors in different hospitals/ICU needs to be considered to improve the ICU discharge process.Researchers and clinicians should consider targeted context‐specific interventions and strategies to optimise patient discharge process from ICUs.The study findings will inform the development of tailored interventions to reduce the discharge delay and after‐hours discharge and, in turn, improve the quality and safety of patient care and health service efficiency.The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines.Patients' discharge processes were observed, and consumer representatives were involved in the study design. [ABSTRACT FROM AUTHOR]