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The impact of frailty on mortality after heart transplantation

Authors :
Christopher S. Hayward
Peter S. Macdonald
Fiona Lam
Kay Wilhelm
Rachel Pierce
E. Montgomery
Natasha Gorrie
Arjun Iyer
Kavitha Muthiah
Mark Connellan
Paul Jansz
Ricardo De Silva
Eugene Kotlyar
Andrew Jabbour
Bruno Schnegg
Emily Granger
Sunita R Jha
A. Watson
Samira R. Aili
Xavier Brennan
Anne Keogh
Rodrigo Fritis-Lamora
Publication Year :
2020
Publisher :
Elsevier, 2020.

Abstract

BACKGROUND Frailty is prevalent in the patients with advanced heart failure; however, its impact on clinical outcomes after heart transplantation (HTx) is unclear. The aim of this study was to assess the impact of pre-transplant frailty on mortality and the duration of hospitalization after HTx. METHODS We retrospectively reviewed the post-transplant outcomes of 140 patients with advanced heart failure who had undergone frailty assessment within the 6-month interval before HTx: 43 of them were frail (F) and 97 were non-frail (NF). RESULTS Post-transplant survival rates for the NF cohort at 1 and 12 months were 97% (93–100) and 95% (91–99) (95% CI), respectively. In contrast, post-transplant survival rates for the F cohort at the same time points were 86% (76–96) and 74% (60–84) (p < 0.0008 vs NF cohort), respectively. The Cox proportional hazards regression analysis demonstrated that pre-transplant frailty was an independent predictor of post-transplant mortality with a hazard ratio of 3.8 (95% CI: 1.4–10.5). Intensive care unit and hospital length of stay were 2 and 7 days longer in the F cohort (both p < 0.05), respectively, than in the NF cohort. CONCLUSIONS Frailty within 6 months before HTx is independently associated with increased mortality and prolonged hospitalization after transplantation. Future research should focus on the development of strategies to mitigate the adverse effects of pre-transplant frailty.

Details

Language :
English
Database :
OpenAIRE
Accession number :
edsair.doi.dedup.....810c12bc23ee0c2ff312d97d199419a7