Title: Frailty-Associated Functional Assessment in Advanced Heart Failure: Predicting Postoperative Length of Stay 

Author:
Heather L. Gates, OTD, OTR/L
Elyse Peterson, OTD, OTR/L
Lauren M. Decker, DPT, PT 

JACOT Volume 6, Issue 1

Abstract

Background
Patients with advanced heart failure (HF) often demonstrate impaired physical function and/or frailty which may negatively impact outcomes following orthotopic heart transplantation (OHT) or left ventricular assist device (LVAD) implantation. Frailty assessment stratifies patients at higher risk for postoperative complications and/or mortality following solid organ transplants, however limited research identifies risk for individuals with HF. This study investigated whether four functional performance measures associated with frailty predicted postoperative outcomes following OHT or LVAD implantation.
Methods
A retrospective chart review collected data on individuals who underwent OHT or LVAD implantation between 2015 and 2018 at a single medical center. Patients were included if they underwent both occupational and physical therapy evaluations that recorded the investigated preoperative measures prior to decision for surgical intervention. Linear regression analyses were used.
Results
Lower performance on three functional outcome measures (composite activity of daily living level, Five Times Sit-to-Stand score, and assistive device use) were significantly associated with longer postoperative length of stays.
Conclusion
Frailty assessment inclusive of physical and occupational performance measures, such as those studied here, may help identify patients with greater operative risk and who may benefit from prehabilitation services. Occupational and physical therapists add value to interdisciplinary teams evaluating candidacy for advanced HF therapies.