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Background: Frailty predicts poor outcome after vascular surgery. We determined the predictive utility of the modified frailty index (mFI) after first-time revascularization and identified biomarkers of frailty predictive of outcome in veterans with peripheral arterial disease.
Methods: A retrospective study was performed of first-time revascularizations (open surgery [OS] and endovascular surgery [ES]) in male veterans (2003-2016). Preoperative mFI scores were calculated, and serum and nonserum biomarkers of frailty were recorded. The primary endpoint was 2-y incidence of reintervention, amputation, and mortality. Secondary endpoints included 30-day morbidity and readmissions.
Results: Four hundred and thirty one patients (OS, n = 188; ES, n = 243), mean age of 66 ± 9 y, and 16 mo of median follow-up were studied. Mean mFI was 0.39 ± 0.16 for OS and 0.38 ± 0.15 for ES (P = 0.43). 30-day complications (adjusted odds ratio, 4.89; 95% confidence interval [CI]: 1.67-14.33) and readmissions (adjusted hazard ratio [aHR] 3.32; 95% CI: 1.16-9.55) were increased in the OS versus ES group when stratified by mFI. Survival analysis showed a correlation between risk of amputation, death, and composite outcome with increasing mFI (P < 0.005) in both groups. Frailty independently predicted major amputation (aHR 2.16; 1.06-4.39), mortality (aHR 2.62; 95% CI: 1.17-5.88), and composite outcome (aHR 1.97; 95% CI: 1.06-3.68) when the groups are combined. Except for absolute neutrophil count, all preoperative lab values correlated with mFI (P < 0.5). Higher albumin was independently associated with lower risk of amputation (aHR: 0.58 [0.36-0.94]) and mortality (aHR: 0.45 [0.25-0.83]); higher hemoglobin predicted limb salvage (aHR 0.7 [0.62-0.84]).
Conclusions: Frailty predicts short- and long-term outcomes after first-time revascularization in veterans. Hypoalbuminemia and anemia are associated with higher mFI and independently predict poor outcome, suggesting albumin and hemoglobin are viable biomarkers of frailty in veterans.
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http://dx.doi.org/10.1016/j.jss.2019.06.040 | DOI Listing |
Alzheimers Dement
December 2024
Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.
Introduction: The retinal nerve fiber layer (RNFL) or ganglion cell-inner plexiform layer (GC-IPL) is associated with cognitive impairment. However, the relationship between retinal asymmetry and cognitive frailty (CF) remains unknown.
Methods: Two hundred twenty-two community-dwelling older adults were assessed starting in 2015 and underwent biennial cognitive and frailty evaluations until 2022.
J Gerontol A Biol Sci Med Sci
December 2024
Human Nutrition & Exercise Research Centre, Centre for Healthier Lives, Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK.
Biomarkers of ageing serve as important outcome measures in longevity-promoting interventions. However, there is limited consensus on which specific biomarkers are most appropriate for human intervention studies. This work aimed to address this need by establishing an expert consensus on biomarkers of ageing for use in intervention studies via the Delphi method.
View Article and Find Full Text PDFJ Geriatr Oncol
December 2024
University of North Carolina School of Medicine, Chapel Hill, NC, USA; Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA.
BMC Public Health
December 2024
The First Clinical Medical College, Jinan University, Guangzhou, China.
Background: Complete blood cell count (CBC)-derived inflammatory biomarkers are crucial indicators of adverse outcomes and possess predictive value for a wide range of diseases. The objective of this study was to evaluate the links between CBC-derived inflammatory biomarkers and frailty index.
Methods: Information was gathered from the National Health and Nutrition Examination Survey (NHANES) spanning the years 1999 to 2016.
J Cancer Surviv
December 2024
College of Nursing, Chungnam National University, 266 Munhwa-Ro, Jung-Gu, Daejeon, South Korea, 35015.
Purpose: Frailty is a major concern in the aging cancer population. It can progress to severe frailty or death or improve to pre-frail or non-frail states. However, frailty transitions in older cancer survivors are not well understood.
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