Prospective Assessment of Frailty Using the Fried Criteria in Patients Undergoing Left Ventricular Assist Device Therapy.

Autor: Joseph SM; Center for Advanced Heart and Lung Disease, Baylor University Medical Center, Dallas, Texas; Annette C. and Harold C. Simmons Transplant Institute, Baylor University Medical Center, Dallas, Texas. Electronic address: Susan.Joseph@BSWHealth.org., Manghelli JL; Department of Surgery, Indiana University, Indianapolis, Indiana., Vader JM; Cardiovascular Division, Washington University School of Medicine, St. Louis, Missouri., Keeney T; Department of Rehabilitation, Massachusetts General Hospital, Boston, Massachusetts., Novak EL; Cardiovascular Division, Washington University School of Medicine, St. Louis, Missouri., Felius J; Annette C. and Harold C. Simmons Transplant Institute, Baylor University Medical Center, Dallas, Texas., Martinez SC; Division of Cardiology, Providence St. Peter Hospital, Olympia, Washington., Nassif ME; Cardiovascular Division, Washington University School of Medicine, St. Louis, Missouri., Lima B; Annette C. and Harold C. Simmons Transplant Institute, Baylor University Medical Center, Dallas, Texas; Department of Cardiac and Thoracic Surgery, Baylor University Medical Center, Dallas, Texas., Silvestry SC; Florida Hospital Transplant Institute, Orlando, Florida., Rich MW; Cardiovascular Division, Washington University School of Medicine, St. Louis, Missouri.
Jazyk: angličtina
Zdroj: The American journal of cardiology [Am J Cardiol] 2017 Oct 15; Vol. 120 (8), pp. 1349-1354. Date of Electronic Publication: 2017 Aug 01.
DOI: 10.1016/j.amjcard.2017.07.074
Abstrakt: 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.
(Copyright © 2017. Published by Elsevier Inc.)
Databáze: MEDLINE
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