What Happens to Frailty in the First Year After Lung Transplantation?

Fuente: Wiley Open Access
Saved in:
Bibliographic Details
Main Authors: Louise Mary Fuller, Helen M. Whitford, Rebecca Robinson, Yvie Cristiano, Ranjana Steward, Megan Poulsen, Eldho Paul, Greg Snell
Format: Artículo Open Access
Published: Wiley 2024
Subjects:
Online Access:
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1867013492336230400
author Louise Mary Fuller
Helen M. Whitford
Rebecca Robinson
Yvie Cristiano
Ranjana Steward
Megan Poulsen
Eldho Paul
Greg Snell
author_facet Louise Mary Fuller
Helen M. Whitford
Rebecca Robinson
Yvie Cristiano
Ranjana Steward
Megan Poulsen
Eldho Paul
Greg Snell
Louise Mary Fuller
Helen M. Whitford
Rebecca Robinson
Yvie Cristiano
Ranjana Steward
Megan Poulsen
Eldho Paul
Greg Snell
collection Wiley Open Access
contents What Happens to Frailty in the First Year After Lung Transplantation? Louise Mary Fuller Helen M. Whitford Rebecca Robinson Yvie Cristiano Ranjana Steward Megan Poulsen Eldho Paul Greg Snell Clinical Transplantation ABSTRACTBackgroundFrailty is prevalent in lung transplant (LTx) candidates, but the impact and subsequent frailty trajectory is unclear. This study aimed to investigate frailty over the first year after LTx.MethodPost‐LTx recipients completed a thrice weekly 12‐week directly supervised exercise rehabilitation program. Edmonton Frail Scale (EFS) was used to assess frailty. Primary outcome was 6‐Minute Walk Distance (6MWD) measured at pre‐LTx, prerehabilitation, postrehabilitation, and 1 year post‐LTx.Results106 of 139 recruited participants underwent LTx: mean age 58 years, 48% male, 52% with chronic obstructive pulmonary disease. Mean (± SD) frailty scores pre‐LTx and 1 year post‐LTx were 5.54 ± 2.4 and 3.28 ±1.5. Mean 6MWD improved significantly for all: prerehabilitation 326 m (SD 116), versus postrehabilitation 523 m (SD 101) (p < 0.001) versus 1 year 512 m (SD 120) (p < 0.001). There were significant differences between an EFS > 7 (frail) and EFS ≤ 7 (not frail) for 6MWD, grip strength (GS), anxiety, and depression. Postrehabilitation, there were no significant differences in 6MWD, GS, anxiety, or depression while comparing EFS > 7 versus ≤ 7. At 1 year, there was a significant difference in depression but not 6MWD, GS, or anxiety between those EFS ≤ 7 and > 7 (p = 0.017).ConclusionParticipants in a structured post‐LTx rehabilitation program improved in functional exercise capacity (6MWD), GS, depression, and anxiety. For frail participants exercise capacity, depression, anxiety, and GS were well managed in rehabilitation with no significant differences between those who were not frail. Pre‐LTx frailty may be reversible post‐LTx and should not be an absolute contraindication to LTx. 10.1111/ctr.15393 http://onlinelibrary.wiley.com/termsAndConditions#vor
doi_str_mv 10.1111/ctr.15393
format Artículo Open Access
id wiley_oa_10_1111_ctr_15393
institution Wiley Open Access
license_str_mv http://onlinelibrary.wiley.com/termsAndConditions#vor
publishDate 2024
publisher Wiley
record_format wiley_oa
spellingShingle What Happens to Frailty in the First Year After Lung Transplantation?
Louise Mary Fuller
Helen M. Whitford
Rebecca Robinson
Yvie Cristiano
Ranjana Steward
Megan Poulsen
Eldho Paul
Greg Snell
Clinical Transplantation
What Happens to Frailty in the First Year After Lung Transplantation? Louise Mary Fuller Helen M. Whitford Rebecca Robinson Yvie Cristiano Ranjana Steward Megan Poulsen Eldho Paul Greg Snell Clinical Transplantation ABSTRACTBackgroundFrailty is prevalent in lung transplant (LTx) candidates, but the impact and subsequent frailty trajectory is unclear. This study aimed to investigate frailty over the first year after LTx.MethodPost‐LTx recipients completed a thrice weekly 12‐week directly supervised exercise rehabilitation program. Edmonton Frail Scale (EFS) was used to assess frailty. Primary outcome was 6‐Minute Walk Distance (6MWD) measured at pre‐LTx, prerehabilitation, postrehabilitation, and 1 year post‐LTx.Results106 of 139 recruited participants underwent LTx: mean age 58 years, 48% male, 52% with chronic obstructive pulmonary disease. Mean (± SD) frailty scores pre‐LTx and 1 year post‐LTx were 5.54 ± 2.4 and 3.28 ±1.5. Mean 6MWD improved significantly for all: prerehabilitation 326 m (SD 116), versus postrehabilitation 523 m (SD 101) (p < 0.001) versus 1 year 512 m (SD 120) (p < 0.001). There were significant differences between an EFS > 7 (frail) and EFS ≤ 7 (not frail) for 6MWD, grip strength (GS), anxiety, and depression. Postrehabilitation, there were no significant differences in 6MWD, GS, anxiety, or depression while comparing EFS > 7 versus ≤ 7. At 1 year, there was a significant difference in depression but not 6MWD, GS, or anxiety between those EFS ≤ 7 and > 7 (p = 0.017).ConclusionParticipants in a structured post‐LTx rehabilitation program improved in functional exercise capacity (6MWD), GS, depression, and anxiety. For frail participants exercise capacity, depression, anxiety, and GS were well managed in rehabilitation with no significant differences between those who were not frail. Pre‐LTx frailty may be reversible post‐LTx and should not be an absolute contraindication to LTx. 10.1111/ctr.15393 http://onlinelibrary.wiley.com/termsAndConditions#vor
title What Happens to Frailty in the First Year After Lung Transplantation?
topic Clinical Transplantation
url https://onlinelibrary.wiley.com/doi/10.1111/ctr.15393