Assessing Frailty in Patients Undergoing Destination Therapy Left Ventricular Assist Device: Observations from Interagency Registry for Mechanically Assisted Circulatory Support

ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Lauren B CooperAdrian F Hernandez

Abstract

Frailty and heart failure share common pathways with symptoms that often coexist. Assessment of frailty may inform patient selection for left ventricular assist device (LVAD) therapy. Using Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) data of destination therapy (DT) LVAD patients from January 1, 2012, to March 31, 2014, we examined preimplantation provider-assessed frailty and gait speed testing and the association with 1 year postimplantation outcomes. Of 2,469 patients, 227 (9.2%) had provider-assessed frailty. Only 320 (13.0%) completed gait speed testing, whereas 1,047 (42.4%) were "too sick" to perform the test. Provider-assessed frail and nonfrail patients had similar distributions of INTERMACS profiles and similar median gait speeds. One year mortality was higher for patients with provider-assessed frailty versus nonfrail (24.6% vs. 18.9%; p = 0.01) and for those too sick to complete gait speed testing versus completed testing (22.0% vs. 15.9%). There was an association between provider-assessed frailty and mortality, although it was not clinically significant after adjustment (hazard ratio [HR]: 1.38 [95% confidence interval {CI}: 0.97-1.95]). Useful information regarding frailty on po...Continue Reading

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Citations

Jul 17, 2019·Clinical Transplantation·Michelle M KittlesonJaime D Moriguchi
Aug 11, 2019·Journal of the American Geriatrics Society·Ersilia M DeFilippisVeli K Topkara
May 18, 2019·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Evgenij V PotapovFinn Gustafsson
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Aug 26, 2021·Heart & Lung : the Journal of Critical Care·Sarah E SchroederWindy W Alonso
Feb 13, 2021·Transplantation·Peter Macdonald

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