Reversibility of Frailty after Lung Transplantation.

Montgomery, E; Macdonald, PS; Newton, PJ; Chang, S; Wilhelm, K; Jha, SR; Malouf, M

Reversibility of Frailty after Lung Transplantation.

Montgomery, E

Macdonald, PS Newton, PJ Chang, S

Wilhelm, K Jha, SR Malouf, M

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Publisher:: Hindawi Limited
Publication Type:: Journal Article
Citation:: Journal of transplantation, 2020, 2020
Issue Date:: 2020-01

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Field	Value	Language
dc.contributor.author	Montgomery, E https://orcid.org/0000-0003-3470-6901
dc.contributor.author	Macdonald, PS
dc.contributor.author	Newton, PJ
dc.contributor.author	Chang, S https://orcid.org/0000-0003-0723-3192
dc.contributor.author	Wilhelm, K
dc.contributor.author	Jha, SR
dc.contributor.author	Malouf, M
dc.date.accessioned	2020-09-16T03:59:54Z
dc.date.available	2020-07-24
dc.date.available	2020-09-16T03:59:54Z
dc.date.issued	2020-01
dc.identifier.citation	Journal of transplantation, 2020, 2020
dc.identifier.issn	2090-0007
dc.identifier.issn	2090-0015
dc.identifier.uri	http://hdl.handle.net/10453/142697
dc.description.abstract	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.
dc.format	Electronic-eCollection
dc.language	eng
dc.publisher	Hindawi Limited
dc.relation.ispartof	Journal of transplantation
dc.relation.isbasedon	10.1155/2020/3239495
dc.rights	info:eu-repo/semantics/openAccess
dc.title	Reversibility of Frailty after Lung Transplantation.
dc.type	Journal Article
utslib.citation.volume	2020
utslib.location.activity	United States
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Strength - CHSP - Health Services and Practice
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/IMPACCT
utslib.copyright.status	open_access	*
pubs.consider-herdc	false
dc.date.updated	2020-09-16T03:59:33Z
pubs.publication-status	Published
pubs.volume	2020

Abstract:

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.

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http://hdl.handle.net/10453/142697