Cognitive impairment improves the predictive validity of physical frailty for mortality in patients with advanced heart failure referred for heart transplantation
Section snippets
Methods
The St Vincent’s Hospital Research Ethics Committee reviewed and approved this study (HREC Reference number LNR/13/SVH/21). Informed consent was obtained from all patients for their data to be entered prospectively into a dedicated database for subsequent analysis.
Prevalence of frailty
Frailty was assessed in 156 patients (109 men and 47 women; age 53 ± 13 years, range 16–73 years; LVEF 27% ± 14%) as part of their transplant referral work-up. Of these, 108 were accepted for transplantation, 22 were considered too well, and 26 were determined to be medically unsuitable. The underlying causes of heart failure were dilated cardiomyopathy (55%), ischemic heart disease (26%), hypertrophic or restrictive cardiomyopathy (13%), and other cardiac diseases (6%).
Baseline characteristics
Discussion
There is ongoing debate regarding the concept of frailty as a multidimensional syndrome of accumulated deficits spanning physical, psychosocial, and functional domains as opposed to a unidimensional syndrome based on a physical-biologic phenotype.15 This has led to 2 fundamental definitions from which most working measures of frailty have evolved: the frailty phenotype proposed by Fried et al 7 and the Rockwood Frailty Index.16, 17 The frailty phenotype proposed by Fried et al involves the
Disclosure statement
None of the authors has a financial relationship with a commercial entity that has an interest in the subject of the presented manuscript or other conflicts of interest to disclose.
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