Reversibility of Frailty after Lung Transplantation
Background. Frailty contributes to increased morbidity and mortality in patients referred for and undergoing lung transplantation (LTX). The study aim was to determine if frailty is reversible after LTX in those classified as frail at LTX evaluation. Methods. Consecutive LTX recipients were included...
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| Format: | Article |
| Language: | English |
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Wiley
2020-01-01
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| Series: | Journal of Transplantation |
| Online Access: | http://dx.doi.org/10.1155/2020/3239495 |
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| author | Elyn Montgomery Peter S. Macdonald Phillip J. Newton Sungwon Chang Kay Wilhelm Sunita R. Jha Monique Malouf |
| author_facet | Elyn Montgomery Peter S. Macdonald Phillip J. Newton Sungwon Chang Kay Wilhelm Sunita R. Jha Monique Malouf |
| author_sort | Elyn Montgomery |
| collection | DOAJ |
| description | Background. Frailty contributes to increased morbidity and mortality in patients referred for and undergoing lung transplantation (LTX). The study aim was to determine if frailty is reversible after LTX in those classified as frail at LTX evaluation. Methods. Consecutive LTX recipients were included. All patients underwent modified physical frailty assessment during LTX evaluation. For patients assessed as frail, frailty was reassessed on completion of the post-LTX rehabilitation program. Frailty was defined by the presence of ≥ 3 domains of the modified Fried Frailty Phenotype (mFFP). Results. We performed 166 lung transplants (frail patients, n = 27, 16%). Eighteen of the 27 frail patients have undergone frailty reassessment. Eight frail patients died, and one interstate recipient did not return for reassessment. In the 18 (66%) patients reassessed, there was an overall reduction in their frailty score post-LTX ((3.4 ± 0.6 to 1.0 ± 0.7), p<0.001) with 17/18 (94%) no longer classified as frail. Improvements were seen in the following frailty domains: exhaustion, mobility, appetite, and activity. Handgrip strength did not improve posttransplant. Conclusions. Physical frailty was largely reversible following LTX, underscoring the importance of considering frailty a dynamic, not a fixed, entity. Further work is needed to identify those patients whose frailty is modifiable and establish specific interventions to improve frailty. |
| format | Article |
| id | doaj-art-7dce8d1136e04fbc97f694520457083d |
| institution | Kabale University |
| issn | 2090-0007 2090-0015 |
| language | English |
| publishDate | 2020-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Transplantation |
| spelling | doaj-art-7dce8d1136e04fbc97f694520457083d2025-02-03T05:44:16ZengWileyJournal of Transplantation2090-00072090-00152020-01-01202010.1155/2020/32394953239495Reversibility of Frailty after Lung TransplantationElyn Montgomery0Peter S. Macdonald1Phillip J. Newton2Sungwon Chang3Kay Wilhelm4Sunita R. Jha5Monique Malouf6Faculty of Health, University of Technology Sydney, Sydney, NSW, AustraliaHeart & Lung Transplant Program, St Vincent’s Hospital, Sydney, NSW, AustraliaWestern Sydney University, School of Nursing and Midwifery, Sydney, NSW, AustraliaFaculty of Health, University of Technology Sydney, Sydney, NSW, AustraliaHeart & Lung Transplant Program, St Vincent’s Hospital, Sydney, NSW, AustraliaFaculty of Health, University of Technology Sydney, Sydney, NSW, AustraliaHeart & Lung Transplant Program, St Vincent’s Hospital, Sydney, NSW, AustraliaBackground. Frailty contributes to increased morbidity and mortality in patients referred for and undergoing lung transplantation (LTX). The study aim was to determine if frailty is reversible after LTX in those classified as frail at LTX evaluation. Methods. Consecutive LTX recipients were included. All patients underwent modified physical frailty assessment during LTX evaluation. For patients assessed as frail, frailty was reassessed on completion of the post-LTX rehabilitation program. Frailty was defined by the presence of ≥ 3 domains of the modified Fried Frailty Phenotype (mFFP). Results. We performed 166 lung transplants (frail patients, n = 27, 16%). Eighteen of the 27 frail patients have undergone frailty reassessment. Eight frail patients died, and one interstate recipient did not return for reassessment. In the 18 (66%) patients reassessed, there was an overall reduction in their frailty score post-LTX ((3.4 ± 0.6 to 1.0 ± 0.7), p<0.001) with 17/18 (94%) no longer classified as frail. Improvements were seen in the following frailty domains: exhaustion, mobility, appetite, and activity. Handgrip strength did not improve posttransplant. Conclusions. Physical frailty was largely reversible following LTX, underscoring the importance of considering frailty a dynamic, not a fixed, entity. Further work is needed to identify those patients whose frailty is modifiable and establish specific interventions to improve frailty.http://dx.doi.org/10.1155/2020/3239495 |
| spellingShingle | Elyn Montgomery Peter S. Macdonald Phillip J. Newton Sungwon Chang Kay Wilhelm Sunita R. Jha Monique Malouf Reversibility of Frailty after Lung Transplantation Journal of Transplantation |
| title | Reversibility of Frailty after Lung Transplantation |
| title_full | Reversibility of Frailty after Lung Transplantation |
| title_fullStr | Reversibility of Frailty after Lung Transplantation |
| title_full_unstemmed | Reversibility of Frailty after Lung Transplantation |
| title_short | Reversibility of Frailty after Lung Transplantation |
| title_sort | reversibility of frailty after lung transplantation |
| url | http://dx.doi.org/10.1155/2020/3239495 |
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