The impact of frailty on mortality after heart transplantation.

Macdonald, PS; Gorrie, N; Brennan, X; Aili, SR; De Silva, R; Jha, SR; Fritis-Lamora, R; Montgomery, E; Wilhelm, K; Pierce, R; Lam, F; Schnegg, B; Hayward, C; Jabbour, A; Kotlyar, E; Muthiah, K; Keogh, AM; Granger, E; Connellan, M; Watson, A; Iyer, A; Jansz, PC

The impact of frailty on mortality after heart transplantation.

Macdonald, PS Gorrie, N Brennan, X Aili, SR De Silva, R Jha, SR Fritis-Lamora, R Montgomery, E

Wilhelm, K Pierce, R Lam, F Schnegg, B Hayward, C Jabbour, A Kotlyar, E Muthiah, K Keogh, AM Granger, E Connellan, M Watson, A Iyer, A Jansz, PC

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Publisher:: Elsevier
Publication Type:: Journal Article
Citation:: Journal of Heart and Lung Transplantation, 2021, 40, (2), pp. 87-94
Issue Date:: 2021-02-01

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Field	Value	Language
dc.contributor.author	Macdonald, PS
dc.contributor.author	Gorrie, N
dc.contributor.author	Brennan, X
dc.contributor.author	Aili, SR
dc.contributor.author	De Silva, R
dc.contributor.author	Jha, SR
dc.contributor.author	Fritis-Lamora, R
dc.contributor.author	Montgomery, E https://orcid.org/0000-0003-3470-6901
dc.contributor.author	Wilhelm, K
dc.contributor.author	Pierce, R
dc.contributor.author	Lam, F
dc.contributor.author	Schnegg, B
dc.contributor.author	Hayward, C
dc.contributor.author	Jabbour, A
dc.contributor.author	Kotlyar, E
dc.contributor.author	Muthiah, K
dc.contributor.author	Keogh, AM
dc.contributor.author	Granger, E
dc.contributor.author	Connellan, M
dc.contributor.author	Watson, A
dc.contributor.author	Iyer, A
dc.contributor.author	Jansz, PC
dc.date.accessioned	2021-11-17T04:48:19Z
dc.date.available	2020-11-16
dc.date.available	2021-11-17T04:48:19Z
dc.date.issued	2021-02-01
dc.identifier.citation	Journal of Heart and Lung Transplantation, 2021, 40, (2), pp. 87-94
dc.identifier.issn	0887-2570
dc.identifier.issn	1557-3117
dc.identifier.uri	http://hdl.handle.net/10453/151666
dc.description.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.
dc.format	Print-Electronic
dc.language	eng
dc.publisher	Elsevier
dc.relation	http://purl.org/au-research/grants/nhmrc/1074386
dc.relation.ispartof	Journal of Heart and Lung Transplantation
dc.relation.isbasedon	10.1016/j.healun.2020.11.007
dc.rights	info:eu-repo/semantics/closedAccess
dc.subject	1102 Cardiorespiratory Medicine and Haematology
dc.subject.classification	Surgery
dc.title	The impact of frailty on mortality after heart transplantation.
dc.type	Journal Article
utslib.citation.volume	40
utslib.location.activity	United States
utslib.for	1102 Cardiorespiratory Medicine and Haematology
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/IMPACCT
utslib.copyright.status	closed_access	*
pubs.consider-herdc	false
dc.date.updated	2021-11-17T04:48:18Z
pubs.issue	2
pubs.publication-status	Published
pubs.volume	40
utslib.citation.issue	2

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.

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http://hdl.handle.net/10453/151666