Minn. — Frailty can affect people of all ages and
demographics. Defined simply as "an increased
vulnerability to adverse health outcomes," frailty can
affect a patient’s chances of surviving a surgical procedure
or needing a nursing home. A new study from physicians at Mayo
Clinic in Rochester, Minn., published recently in the Journal
of Heart and Lung Transplantation, is among the first to show
a definitive connection between frailty and survival after a
lung transplant procedure.
Clinic researchers studied 102 individuals who received lung
transplants at Mayo Clinic between Jan. 1, 2002, and Dec. 31,
2013, and found that patients who were frail had a decreased
survival rate compared to patients who were not frail.
to the report, 46 percent of the patients studied were
considered to be frail based on an assessment of 14 activities
of daily living, such as difficulty climbing stairs,
dependency on oxygen or noninvasive ventilation for normal
breathing and difficulty with housekeeping chores. Of those
considered to be frail, 63 percent were female with an average
age of 57. Within this study population, there were 32 deaths
within the first three years post-transplant.
on this population, we saw a definitive association between
pre-transplant frailty and decreased survival after
transplantation," says Cassie Kennedy, M.D., Pulmonology
and Critical Care Medicine, Mayo Clinic. "This suggests
that we may be able to help patients live longer with fewer
complications after a transplant by intervening early to
prevent or lessen the severity of frailty."
to Kennedy, Mayo Clinic researchers found that the one-year
survival rate for frail patients was 71.7 percent, compared to
92.9 percent for patients who were not frail. At three years,
the survival rate for frail patients was 41.3 percent,
compared to 66.1 percent for patients who were not frail.
the connection between frailty and lung transplant survival
and outcomes can help physicians deliver a more accurate
prognosis for transplant patients and, ultimately, get
patients and their families engaged in taking steps to improve
long-term outcomes and survival," says Kennedy.
adds that future studies in this area will more clearly define
the role that frailty plays in identifying candidates for lung
transplantation, with the potential to influence selection
guidelines and transplant center policies.