Frailty in adults hospitalised due to acute exacerbation of chronic lung disease: a comparison of assessment methods.

Abstract

Background: Frailty is detectable and common (up to 40%) in people with acute exacerbations of COPD, however is not routinely assessed in clinical practice, particularly in chronic lung diseases other than COPD. Various tools exist to evaluate frailty, each possessing pros and cons. We sought to compare the performance of two different frailty assessment methods across a variety of conditions to explore their impact. Method(s): Data were prospectively collected from sequential patients admitted to a major public hospital network in Melbourne, Australia between March to July 2021. Patients must have had a primary diagnosis of asthma, bronchiectasis, COPD, ILD, lung cancer or pneumonia. Frailty was assessed via Fried phenotype and FRAIL Scale during their inpatient admission (both tools) and 1-month later via telephone (FRAIL Scale). The relationship between raw tool scores was compared via Pearson's r correlation coefficient; prevalence of frailty status was compared descriptively and visually. Result(s): 77 participants were recruited (46 female; mean 62 years; FEV 71% pred; BMI 29.7). Frailty was detectable in similar proportions using Fried or FRAIL (overall 41.6% vs 51.9%; described further in Table). Scores demonstrated moderate correlation (r=0.55). 15/24 participants were persistently frail from admission to follow-up (FRAIL Scale). % cases Asthma (n=11) Bronchiectasis (n=4) COPD (n=29) ILD (n=3) Lung cancer (n=3) Pneumonia (n=26) FRAIL Scale 15 7.5 35 7.5 7.5 27.5 Fried 12.5 6.3 40.6 6.3 6.3 28.1 Open in new tab Conclusion(s): Frailty is detectable across various conditions during acute respiratory hospitalisation. Consideration should be given to choice of assessment method.