| Affiliation: | 1. Department of Medicine, University of California, CA, USA;2. Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, PA, USA;3. Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, NY, USA;4. Department of Surgery, University of California, CA, USA;5. Penn Transplant Institute, University of Pennsylvania, Philadelphia, PA, USA;6. Department of Surgery, University of Pennsylvania School of Medicine, Philadelphia, PA, USA;7. Department of Surgery, College of Physicians and Surgeons, Columbia University, New York, NY, USA;8. Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Philadelphia, PA, USA;9. Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA |
| Abstract: | Frailty is associated with increased mortality among lung transplant candidates. We sought to determine the association between frailty, as measured by the Short Physical Performance Battery (SPPB), and mortality after lung transplantation. In a multicenter prospective cohort study of adults who underwent lung transplantation, preoperative frailty was assessed with the SPPB (n = 318) and, in a secondary analysis, the Fried Frailty Phenotype (FFP; n = 299). We tested the association between preoperative frailty and mortality following lung transplantation with propensity score–adjusted Cox models. We calculated postestimation marginalized standardized risks for 1‐year mortality by frailty status using multivariate logistic regression. SPPB frailty was associated with an increased risk of both 1‐ and 4‐year mortality (adjusted hazard ratio [aHR]: 7.5; 95% confidence interval [CI]: 1.6‐36.0 and aHR 3.8; 95%CI: 1.8‐8.0, respectively). Each 1‐point worsening in SPPB was associated with a 20% increased risk of death (aHR: 1.20; 95%CI: 1.08‐1.33). Frail subjects had an absolute increased risk of death within the first year after transplantation of 12.2% (95%CI: 3.1%‐21%). In secondary analyses, FFP frailty was associated with increased risk of death within the first postoperative year (aHR: 3.8; 95%CI: 1.1‐13.2) but not over longer follow‐up. Preoperative frailty is associated with an increased risk of death after lung transplantation. |
