featured papersFrailty trajectories in adult lung transplantation: A cohort study
Section snippets
Study design, participants, and setting
We studied participants in the Breathe Again study, a prospective cohort of adults undergoing first-time lung transplantation between 2010 and 2017 at the University of California, San Francisco,12 assessing the impact of lung transplant on functional status, disability, and HRQL. We assessed measures of physical frailty at the time of transplant listing and repeatedly up to three years after transplant on the same days as routinely scheduled clinical visits (at 3, 6, 12, 18, 24, 30, and 36
Results
Among the 276 subjects who underwent lung transplant, 246 (89%) had baseline frailty assessments before transplant and formed the cohort for analysis (244 subjects with SPPB, 162 with FFP, and 160 with both). Fewer subjects had FFP because this measure was introduced two years after study initiation (Table 1 and Figure 1). The mean time from baseline SPPB assessment to transplant was 76 (range 0‒441) days with median of 53 days (interquartile range [IQR] 21‒107 days). The mean time from
Discussion
In this longitudinal cohort study of frailty trajectories in lung transplantation, we found that frailty, defined by both the Short Physical Performance Battery (SPPB) and the Fried Frailty Phenotype (FFP), improved to a clinically meaningful extent early after transplant and remained stable thereafter. Most notably, the majority of subjects who were frail before transplant no longer met frailty criteria by either measure at 6 months after transplantation. Our study suggests that, for the
Disclosure statement
The authors have no conflicts of interest to disclose. We thank all the patients for their participation in this study. This work was supported by grants from the National Heart, Lung and Blood Institute (K23 HL111115 and R01 HL134851 to J.P.S.) and the Clinical Sciences Research & Development Service of the VA Office of Research and Development (career development award IK2CX001034 to J.R.G.).
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