Evaluation of frailty in geriatric patients undergoing cardiac rehabilitation after cardiac procedure: results of a prospective, cross-sectional study

Carolin Steinmetz; Laura Krause; Samra Sulejmanovic; Sabrina Kaumkötter; Johanneke Hartog; Bart Scheenstra; Flohr Stefan; Thomas Mengden; Clemens Grefe; Ernst Knoglinger; Nils Reiss; Birna Bjarnason-Wehrens; Thomas Schmidt; Monika Sadlonova; Christine A F von Arnim; Stephanie Heinemann

doi:10.1186/s13102-024-00937-y

Evaluation of frailty in geriatric patients undergoing cardiac rehabilitation after cardiac procedure: results of a prospective, cross-sectional study

Carolin Steinmetz, Laura Krause, Samra Sulejmanovic, Sabrina Kaumkötter, Johanneke Hartog, Bart Scheenstra, Flohr Stefan, Thomas Mengden, Clemens Grefe, Ernst Knoglinger, Nils Reiss, Birna Bjarnason-Wehrens, Thomas Schmidt, Monika Sadlonova, Christine A F von Arnim, Stephanie Heinemann

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Abstract

BACKGROUND: Frailty is an indicator of a decline in quality of life and functional capacity in cardiac rehabilitation (CR) patients. Currently, there is no standardized assessment tool for frailty used in CR. The aim of this study was to determine if the Clinical Frailty Scale (CFS) is feasible for assessing frailty in CR.

METHODS: Prospective, cross-sectional study within the framework of the ongoing multicenter prehabilitation study "PRECOVERY". Patients ≥75 years undergoing CR after cardiac procedure (n=122) were recruited in four German inpatient CR facilities. Assessments included: CFS, Katz-Index, hand grip strength (HGS), Short Physical Performance Battery (SPPB) and six-minute-walk test (6MWT). Outcomes were frailty (CFS≥4) and the correlation of frailty with assessments of functional capacity, activities of daily living and clinical parameters. Statistical analysis included descriptive statistics and correlations, using the spearman correlation coefficient and chi-square test to test for significance.

RESULTS: Data from 101 patients (79.9±4.0 years; 63% male) were analyzed. The mean CFS score was 3.2±1.4; 41.6% were defined as frail (CFS≥4). The mean time required to assess the CFS was 0.20 minutes. The findings show that CFS correlates significantly (p<0.001) with the following factors: Katz-Index, HGS, SPPB-Score and 6MWT (r≤-0.575). In addition, CFS correlated with small to moderate effects with co-morbidities (r=0.250), as-needed medications and need for nursing assistance (r≤0.248).

CONCLUSIONS: The CFS assessment can be performed in under one minute and it correlates significantly with assessments of functional capacity, activities of daily living and clinical parameters in the CR setting.

TRIAL REGISTRATION: German Clinical Trials Register (DRKS; http:// www. drks. de; DRKS00032256). Retrospectively registered on 13 July 2023.

Original language	English
Article number	146
Number of pages	10
Journal	BMC Sports Science, Medicine and Rehabilitation
Volume	16
DOIs	https://doi.org/10.1186/s13102-024-00937-y
Publication status	Published - 2-Jul-2024

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Steinmetz, C., Krause, L., Sulejmanovic, S., Kaumkötter, S., Hartog, J., Scheenstra, B., Stefan, F., Mengden, T., Grefe, C., Knoglinger, E., Reiss, N., Bjarnason-Wehrens, B., Schmidt, T., Sadlonova, M., von Arnim, C. A. F., & Heinemann, S. (2024). Evaluation of frailty in geriatric patients undergoing cardiac rehabilitation after cardiac procedure: results of a prospective, cross-sectional study. BMC Sports Science, Medicine and Rehabilitation, 16, Article 146. https://doi.org/10.1186/s13102-024-00937-y

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title = "Evaluation of frailty in geriatric patients undergoing cardiac rehabilitation after cardiac procedure: results of a prospective, cross-sectional study",

abstract = "BACKGROUND: Frailty is an indicator of a decline in quality of life and functional capacity in cardiac rehabilitation (CR) patients. Currently, there is no standardized assessment tool for frailty used in CR. The aim of this study was to determine if the Clinical Frailty Scale (CFS) is feasible for assessing frailty in CR.METHODS: Prospective, cross-sectional study within the framework of the ongoing multicenter prehabilitation study {"}PRECOVERY{"}. Patients ≥75 years undergoing CR after cardiac procedure (n=122) were recruited in four German inpatient CR facilities. Assessments included: CFS, Katz-Index, hand grip strength (HGS), Short Physical Performance Battery (SPPB) and six-minute-walk test (6MWT). Outcomes were frailty (CFS≥4) and the correlation of frailty with assessments of functional capacity, activities of daily living and clinical parameters. Statistical analysis included descriptive statistics and correlations, using the spearman correlation coefficient and chi-square test to test for significance.RESULTS: Data from 101 patients (79.9±4.0 years; 63% male) were analyzed. The mean CFS score was 3.2±1.4; 41.6% were defined as frail (CFS≥4). The mean time required to assess the CFS was 0.20 minutes. The findings show that CFS correlates significantly (p<0.001) with the following factors: Katz-Index, HGS, SPPB-Score and 6MWT (r≤-0.575). In addition, CFS correlated with small to moderate effects with co-morbidities (r=0.250), as-needed medications and need for nursing assistance (r≤0.248).CONCLUSIONS: The CFS assessment can be performed in under one minute and it correlates significantly with assessments of functional capacity, activities of daily living and clinical parameters in the CR setting.TRIAL REGISTRATION: German Clinical Trials Register (DRKS; http:// www. drks. de; DRKS00032256). Retrospectively registered on 13 July 2023.",

author = "Carolin Steinmetz and Laura Krause and Samra Sulejmanovic and Sabrina Kaumk{\"o}tter and Johanneke Hartog and Bart Scheenstra and Flohr Stefan and Thomas Mengden and Clemens Grefe and Ernst Knoglinger and Nils Reiss and Birna Bjarnason-Wehrens and Thomas Schmidt and Monika Sadlonova and {von Arnim}, {Christine A F} and Stephanie Heinemann",

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doi = "10.1186/s13102-024-00937-y",

language = "English",

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journal = "BMC Sports Science, Medicine and Rehabilitation",

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Steinmetz, C, Krause, L, Sulejmanovic, S, Kaumkötter, S, Hartog, J, Scheenstra, B, Stefan, F, Mengden, T, Grefe, C, Knoglinger, E, Reiss, N, Bjarnason-Wehrens, B, Schmidt, T, Sadlonova, M, von Arnim, CAF & Heinemann, S 2024, 'Evaluation of frailty in geriatric patients undergoing cardiac rehabilitation after cardiac procedure: results of a prospective, cross-sectional study', BMC Sports Science, Medicine and Rehabilitation, vol. 16, 146. https://doi.org/10.1186/s13102-024-00937-y

Evaluation of frailty in geriatric patients undergoing cardiac rehabilitation after cardiac procedure: results of a prospective, cross-sectional study. / Steinmetz, Carolin; Krause, Laura; Sulejmanovic, Samra et al.
In: BMC Sports Science, Medicine and Rehabilitation, Vol. 16, 146, 02.07.2024.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - Evaluation of frailty in geriatric patients undergoing cardiac rehabilitation after cardiac procedure

T2 - results of a prospective, cross-sectional study

AU - Steinmetz, Carolin

AU - Krause, Laura

AU - Sulejmanovic, Samra

AU - Kaumkötter, Sabrina

AU - Hartog, Johanneke

AU - Scheenstra, Bart

AU - Stefan, Flohr

AU - Mengden, Thomas

AU - Grefe, Clemens

AU - Knoglinger, Ernst

AU - Reiss, Nils

AU - Bjarnason-Wehrens, Birna

AU - Schmidt, Thomas

AU - Sadlonova, Monika

AU - von Arnim, Christine A F

AU - Heinemann, Stephanie

PY - 2024/7/2

Y1 - 2024/7/2

N2 - BACKGROUND: Frailty is an indicator of a decline in quality of life and functional capacity in cardiac rehabilitation (CR) patients. Currently, there is no standardized assessment tool for frailty used in CR. The aim of this study was to determine if the Clinical Frailty Scale (CFS) is feasible for assessing frailty in CR.METHODS: Prospective, cross-sectional study within the framework of the ongoing multicenter prehabilitation study "PRECOVERY". Patients ≥75 years undergoing CR after cardiac procedure (n=122) were recruited in four German inpatient CR facilities. Assessments included: CFS, Katz-Index, hand grip strength (HGS), Short Physical Performance Battery (SPPB) and six-minute-walk test (6MWT). Outcomes were frailty (CFS≥4) and the correlation of frailty with assessments of functional capacity, activities of daily living and clinical parameters. Statistical analysis included descriptive statistics and correlations, using the spearman correlation coefficient and chi-square test to test for significance.RESULTS: Data from 101 patients (79.9±4.0 years; 63% male) were analyzed. The mean CFS score was 3.2±1.4; 41.6% were defined as frail (CFS≥4). The mean time required to assess the CFS was 0.20 minutes. The findings show that CFS correlates significantly (p<0.001) with the following factors: Katz-Index, HGS, SPPB-Score and 6MWT (r≤-0.575). In addition, CFS correlated with small to moderate effects with co-morbidities (r=0.250), as-needed medications and need for nursing assistance (r≤0.248).CONCLUSIONS: The CFS assessment can be performed in under one minute and it correlates significantly with assessments of functional capacity, activities of daily living and clinical parameters in the CR setting.TRIAL REGISTRATION: German Clinical Trials Register (DRKS; http:// www. drks. de; DRKS00032256). Retrospectively registered on 13 July 2023.

AB - BACKGROUND: Frailty is an indicator of a decline in quality of life and functional capacity in cardiac rehabilitation (CR) patients. Currently, there is no standardized assessment tool for frailty used in CR. The aim of this study was to determine if the Clinical Frailty Scale (CFS) is feasible for assessing frailty in CR.METHODS: Prospective, cross-sectional study within the framework of the ongoing multicenter prehabilitation study "PRECOVERY". Patients ≥75 years undergoing CR after cardiac procedure (n=122) were recruited in four German inpatient CR facilities. Assessments included: CFS, Katz-Index, hand grip strength (HGS), Short Physical Performance Battery (SPPB) and six-minute-walk test (6MWT). Outcomes were frailty (CFS≥4) and the correlation of frailty with assessments of functional capacity, activities of daily living and clinical parameters. Statistical analysis included descriptive statistics and correlations, using the spearman correlation coefficient and chi-square test to test for significance.RESULTS: Data from 101 patients (79.9±4.0 years; 63% male) were analyzed. The mean CFS score was 3.2±1.4; 41.6% were defined as frail (CFS≥4). The mean time required to assess the CFS was 0.20 minutes. The findings show that CFS correlates significantly (p<0.001) with the following factors: Katz-Index, HGS, SPPB-Score and 6MWT (r≤-0.575). In addition, CFS correlated with small to moderate effects with co-morbidities (r=0.250), as-needed medications and need for nursing assistance (r≤0.248).CONCLUSIONS: The CFS assessment can be performed in under one minute and it correlates significantly with assessments of functional capacity, activities of daily living and clinical parameters in the CR setting.TRIAL REGISTRATION: German Clinical Trials Register (DRKS; http:// www. drks. de; DRKS00032256). Retrospectively registered on 13 July 2023.

U2 - 10.1186/s13102-024-00937-y

DO - 10.1186/s13102-024-00937-y

M3 - Article

C2 - 38956610

SN - 2052-1847

VL - 16

JO - BMC Sports Science, Medicine and Rehabilitation

JF - BMC Sports Science, Medicine and Rehabilitation

M1 - 146

ER -

Evaluation of frailty in geriatric patients undergoing cardiac rehabilitation after cardiac procedure: results of a prospective, cross-sectional study

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