BACKGROUND: Frailty is a clinically recognized syndrome of decreased physiological reserve and a key contributor to suboptimal clinical outcomes in various lung disease groups. Interstitial lung disease (ILD) is fast approaching chronic obstructive pulmonary disease as the number one indication for lung transplantation worldwide. Our aim was to assess whether frailty is a predictor of mortality in patients with ILD referred for lung transplantation in an Australian cohort. METHODS: Consecutive patients with ILD referred or on the waiting list for lung transplantation from May 2013 to December 2017 underwent frailty assessment using the modified Fried's frailty phenotype. Frailty was defined as a positive response to ≥3 of the following 5 components: weak grip strength, slowed walking speed, poor appetite, physical inactivity, and exhaustion. RESULTS: One hundred patients (82 male:18 female; age, 59 ± 7 y; range, 30-70) underwent frailty assessment. Twenty-four of 100 (24%) were assessed as frail. Frailty was associated with anemia, hypoalbuminemia, low creatinine, and the use of supplemental oxygen (all P < 0.05). Frailty was independent of age, gender, measures of pulmonary dysfunction (PaO2, forced vital capacity percentage predicted, total lung capacity, total lung capacity percentage predicted, DLCO, or DLCO percentage predicted), cognitive impairment, or depression. Frailty and DLCO % predicted were independent predictors of increased all-cause mortality: 1-year actuarial survival was 86 ± 4% in the nonfrail group compared with 58 ± 10% for the frail group (P = 0.002). CONCLUSIONS: Frailty is common among patients referred for lung transplant with a diagnosis of ILD and is associated with a marked increase in mortality.
BACKGROUND: Frailty is a clinically recognized syndrome of decreased physiological reserve and a key contributor to suboptimal clinical outcomes in various lung disease groups. Interstitial lung disease (ILD) is fast approaching chronic obstructive pulmonary disease as the number one indication for lung transplantation worldwide. Our aim was to assess whether frailty is a predictor of mortality inpatients with ILD referred for lung transplantation in an Australian cohort. METHODS: Consecutive patients with ILD referred or on the waiting list for lung transplantation from May 2013 to December 2017 underwent frailty assessment using the modified Fried's frailty phenotype. Frailty was defined as a positive response to ≥3 of the following 5 components: weak grip strength, slowed walking speed, poor appetite, physical inactivity, and exhaustion. RESULTS: One hundred patients (82 male:18 female; age, 59 ± 7 y; range, 30-70) underwent frailty assessment. Twenty-four of 100 (24%) were assessed as frail. Frailty was associated with anemia, hypoalbuminemia, low creatinine, and the use of supplemental oxygen (all P < 0.05). Frailty was independent of age, gender, measures of pulmonary dysfunction (PaO2, forced vital capacity percentage predicted, total lung capacity, total lung capacity percentage predicted, DLCO, or DLCO percentage predicted), cognitive impairment, or depression. Frailty and DLCO % predicted were independent predictors of increased all-cause mortality: 1-year actuarial survival was 86 ± 4% in the nonfrail group compared with 58 ± 10% for the frail group (P = 0.002). CONCLUSIONS: Frailty is common among patients referred for lung transplant with a diagnosis of ILD and is associated with a marked increase in mortality.
Authors: Lorriana E Leard; Are M Holm; Maryam Valapour; Allan R Glanville; Sandeep Attawar; Meghan Aversa; Silvia V Campos; Lillian M Christon; Marcelo Cypel; Göran Dellgren; Matthew G Hartwig; Siddhartha G Kapnadak; Nicholas A Kolaitis; Robert M Kotloff; Caroline M Patterson; Oksana A Shlobin; Patrick J Smith; Amparo Solé; Melinda Solomon; David Weill; Marlies S Wijsenbeek; Brigitte W M Willemse; Selim M Arcasoy; Kathleen J Ramos Journal: J Heart Lung Transplant Date: 2021-07-24 Impact factor: 13.569
Authors: Joanna M Schaenman; Joshua M Diamond; John R Greenland; Cynthia Gries; Cassie C Kennedy; Amit D Parulekar; Dmitry Rozenberg; Jonathan P Singer; Lianne G Singer; Laurie D Snyder; Sangeeta Bhorade Journal: Am J Transplant Date: 2020-12-24 Impact factor: 9.369
Authors: Gemma F Spiers; Tafadzwa Patience Kunonga; Alex Hall; Fiona Beyer; Elisabeth Boulton; Stuart Parker; Peter Bower; Dawn Craig; Chris Todd; Barbara Hanratty Journal: BMJ Open Date: 2021-03-22 Impact factor: 2.692
Authors: Nicholas Bourgeois; Shirin M Shallwani; Fahad S Al-Huda; Sunita Mathur; Charles Poirier; Tania Janaudis-Ferreira Journal: Transplant Direct Date: 2022-10-07