Feasibility of Frailty Assessment Integrated with Cardiac Implantable Electronic Device Clinic Follow-up: A Pilot Investigation.
Feasibility of Frailty Assessment Integrated with Cardiac Implantable Electronic Device Clinic Follow-up: A Pilot Investigation.
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DOI：
10.1177/2333721420987342
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发表时间：
2021-01
影响因子：
2.7
通讯作者：
Rosenberg MA
中科院分区：
文献类型：
--
作者：
Albakri A;Orkaby A;Rosenberg MA
背景：脆弱的概念最初是为了解释为什么相同年龄的人有不同的疾病风险，后来发现它与包括心血管疾病和心脏手术在内的各种疾病的预后呈负相关。虽然已经提出了许多风险评分和评估工具，但实际评估脆弱性的机会仍然有限。在这项先导性研究中，我们考察了使用心脏可植入电子设备(CIED)的患者进行常规随访以评估其脆弱性的可行性。方法：选择2017年9月至2018年3月在CIED门诊就诊的患者49例。在门诊中进行的虚弱评估包括4米步行时间、虚弱等级计算、另一家治疗提供者的Rockwood虚弱评分评估、迷你齿轮评估以及CIED上的日常活动测量分析。结果：在患者CIEDs的三家设备制造商中，只有波士顿科学公司发布了可分析的活动时间序列数据。在9名可以分析日常活动数据的患者中，平均每日活动(148.3 ± 31.9vs.100.1 ± 25.1min/d，p .27)在有或没有异常脆弱或认知评估的患者之间没有差异，尽管有趣的是，有异常评估的患者每天活动的标准差更高(52.6vs.31.4 ± 5.9vs.31.4 ± 4.7min/d，p .03)。结论：在一年中，日常活动的较高变化可能是比平均每日活动更好的虚弱或认知障碍的指标。
Background: The concept of frailty was originally created to explain why individuals of the same age have differing risk of disease, and it has since been found to be negatively associated with outcomes for a wide range of medical conditions, including cardiovascular disease and cardiac procedures. Although numerous risk scores and assessment tools have been proposed, opportunities for practical assessment of frailty remain limited. In this pilot study, we examine the feasibility of using routine follow-up of patients with cardiac implantable electronic devices (CIEDs) for assessment of frailty. Methods: From September 2017 through March 2018, 49 consecutive patients seen in CIED clinic were enrolled. Among the frailty assessments performed at the clinic visit included a 4-meter walk time, FRAIL scale calculation, Rockwood Frailty score assessment by another treating provider, mini-cog assessment, and analysis of daily activity measures on the CIED. Results: Among the three device manufacturers of patients’ CIEDs, only Boston Scientific released analyzable activity time series data. On nine patients in whom daily activity data could be analyzed, there was no difference in mean daily activity (148.3 ± 31.9 vs. 100.1 ± 25.1 min/day, p = .27) between patients with and without an abnormal frailty or cognitive assessment, although interestingly, those with an abnormal assessment had a higher standard deviation of activity per day (52.6 ± 5.9 vs. 31.4 ± 4.7 min/day, p = .03). Conclusion: It is possible that a higher variation in daily activity over the course of a year could be a better indicator of frailty or cognitive impairment than average daily activity.