The aim of the present study was to investigate the utility of the modified frailty
index (mFI) to predict outcomes in patients who underwent cardiac resynchronization
therapy (CRT) device implantation. A retrospective cohort study of patients undergoing
CRT implantation or upgrade over a 5-year period was performed. The relation between
the preprocedural 11-component mFI and clinical outcomes including 1-year mortality,
periprocedural and 30-day adverse events, 30-day readmission, length of hospitalization
after procedure, and response to CRT defined by changes in left ventricular ejection
fraction and end-diastolic volume were studied. Of 283 patients studied, 134 (47.3%)
were classified as frail (mFI ≥3). Frailty was associated with an increased risk of
1-year mortality (hazard ratio 5.87, p = 0.033 in multivariate analysis), and increased
frequency of adverse events (p = 0.013), 30-day readmission (p = 0.0077), and postprocedural
length of stay ≥3 days (p = 0.0005). Frail patients had significantly less echocardiographic
response to CRT compared with nonfrail patients with change in left ventricular ejection
fraction 6% versus 12% (p = 0.004) and change in left ventricular end-diastolic volume
−19.9 versus −43.3 ml (p = 0.006). In conclusion, frailty as assessed by the mFI is
associated with an increase in 1-year mortality, adverse events, 30-day readmission,
length of stay, and poorer response to CRT after implantation.
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Article info
Publication history
Published online: January 09, 2020
Received in revised form:
December 20,
2019
Received:
November 10,
2019
Footnotes
Funding statement: The authors have no sources of funding to disclose.
Identification
Copyright
© 2020 Elsevier Inc. All rights reserved.
