Prospective assessment of combined handgrip strength and Mini-Cog identifies hospitalized heart failure patients at increased post-hospitalization risk.

AimsThe utility of combined assessment of both frailty and cognitive impairment in hospitalized heart failure (HF) patients for incremental post-discharge risk stratification, using handgrip strength and Mini-Cog as feasible representative parameters, was investigated. Methods and resultsA prospective, single-centre cohort study of older adults (age 65) hospitalized for HF being discharged to home was performed. Pre-discharge, grip strength was assessed using a dynamometer (Jamar hydrolic hand dynamometer, Lafayette Instruments, Lafayette, IN, USA) and was defined as weak if the maximal value was below the gender-derived and body mass index-derived cut-offs according to Fried criteria. Cognition was assessed using the Mini-Cog. The presence of impairment was defined as a score of <2. Outcome measures were all-cause readmission or emergency department visit (primary) or all-cause mortality (secondary) at 6months. A total of 56 patients (mean age 777years, 73% male) were enrolled. The majority (n=33, 59%) had weak grip strength, either with (n=5) or without (n=28) cognitive impairment. The highest risk for both readmission and mortality occurred in those with weak grip strength and cognitive impairment in combination (log-rank P<0.0001 and P=0.01, respectively). ConclusionsPatients who are frail by grip strength assessment and cognitively impaired according to severely reduced Mini-Cog performance show the worst midterm post-discharge outcomes after HF hospitalization.