Frail patients are more prone to adverse events after cardiac surgery, particularly
after implantation of left ventricular assist devices. Thus, frailty assessment may
help identify patients unlikely to benefit from left ventricular assist device therapy.
The purpose was to establish a suitable measure of frailty in adults with end-stage
heart failure. In a prospective cohort of 75 patients (age 58 ± 12 years) with end-stage
heart failure, we assessed the association between frailty (5-component Fried criteria)
and the composite primary outcome of inpatient mortality or prolonged length of stay,
as well as extubation status, time on ventilator, discharge status, and long-term
mortality. Fried frailty criteria were met in 44 (59%) patients, but there was no
association with the primary outcome (p = 0.10). However, an abridged set of 3 criteria
(exhaustion, inactivity, and grip strength) was predictive of the primary outcome
(odds ratio 2.9, 95% confidence interval 1.1 to 7.4), and of time to extubation and
time to discharge. In patients with advanced heart failure, the 5-component Fried
criteria may not be optimally sensitive to clinical differences. In conclusion, an
abridged set of 3 frailty criteria was predictive of the primary outcome and several
secondary outcomes, and may therefore be a clinically useful tool in this population.
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Article Info
Publication History
Published online: August 01, 2017
Accepted:
July 7,
2017
Received:
April 17,
2017
Footnotes
See page 1354 for disclosure information.
Identification
Copyright
© 2017 Published by Elsevier Inc.
