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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- The impact of frailty in older patients with non-ischaemic cardiomyopathy after implantation of cardiac resynchronization therapy defibrillator.Europace. 2015; 17: 598-602
- Utility of frailty assessment for elderly patients undergoing cardiac resynchronization therapy.JACC Clin Electrophysiol. 2017; 3: 1523-1533
- Frailty as a predictor of negative outcomes after cardiac resynchronization therapy.Pacing Clin Electrophysiol. 2018; 41: 572-577
- Frailty syndrome in heart failure patients who are receiving cardiac resynchronization.Pacing Clin Electrophysiol. 2016; 39: 370-374
- Modified frailty as a novel factor in predicting the response to cardiac resynchronization in the elderly population.Clin Interv Aging. 2019; 14: 437-443
- Role of frailty assessment in patients undergoing cardiac interventions.Open Heart. 2014; 1e000033
- A modified frailty index to assess morbidity and mortality after lobectomy.J Surg Res. 2013; 183: 40-46
- Use of the modified frailty index to predict 30-day morbidity and mortality from spine surgery.J Neurosurg Spine. 2016; 25: 537-541
- Modified frailty index can be used to predict adverse outcomes and mortality after lower extremity bypass surgery.Ann Vasc Surg. 2017; 46: 168-177
- Modified frailty index predicts postoperative outcomes in older gastrointestinal cancer patients.J Surg Oncol. 2017; 115: 997-1003
- Association of the modified frailty index with 30-day surgical readmission.JAMA Surg. 2017; 152: 749-757
- Frailty syndrome: an emerging clinical problem in the everyday management of clinical arrhythmias. The results of the European Heart Rhythm Association survey.Europace. 2017; 19: 1896-1902
- The significance of preoperative impaired sensorium on surgical outcomes in nonemergent general surgical operations.JAMA Surg. 2015; 150: 30-36
- Early procedure-related adverse events by gender in MADIT-CRT.J Cardiovasc Electrophysiol. 2014; 25: 985-989
- The prevalence of frailty in heart failure: a systematic review and meta-analysis.Int J Cardiol. 2017; 236: 283-289
- Frailty in older adults: evidence for a phenotype.J Gerontol A Biol Sci Med Sci. 2001; 56: M146-M156
- Evaluation of the Groningen frailty indicator and the G8 questionnaire as screening tools for frailty in older patients with cancer.J Geriatr Oncol. 2013; 4: 32-38
- Cardiac resynchronization therapy in ischemic and non-ischemic cardiomyopathy.J Arrhythm. 2017; 33: 410-416
- Prognostic value of grip strength: findings from the Prospective Urban Rural Epidemiology (PURE) study.Lancet. 2015; 386: 266-273
Published online: January 09, 2020
Received in revised form: December 20, 2019
Received: November 10, 2019
Funding statement: The authors have no sources of funding to disclose.
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