Details

Autor(en) / Beteiligte

• Wickerson, L.
• Rozenberg, D.
• Helm, D.
• Gottesman, C.
• Mathur, S.
• Singer, L.G.

Titel

Short Physical Performance Battery Scores at Lung Transplant Assessment: Relationship to Early Transplant Outcomes and Response to Pre-Habilitation

Ist Teil von

• The Journal of heart and lung transplantation, 2020-04, Vol.39 (4), p.S208-S209

Ort / Verlag

United States: Elsevier Inc

Erscheinungsjahr

2020

Link zum Volltext

Quelle

Elsevier ScienceDirect Journals Complete

Beschreibungen/Notizen

• The short physical performance battery (SPPB) has been used as a measure of phenotypic frailty in adult lung transplant candidates. It is associated with an increased risk of delisting and death pre-transplant, and one-year post transplant mortality. As the SPPB may be used to inform transplant eligibility, we examined if SPPB at transplant assessment predicted early post-transplant outcomes, and if the SPPB was responsive to pre-habilitation. This was a retrospective study of all lung transplant candidates who were accepted for transplant at the University Health Network between June 15, 2016 and December 31, 2018. Supervised rehabilitation is provided pre-transplant for the duration of the waiting period and for the first 3 months post-transplant. SPPB scores were categorized as frail (&lt10/12) and non-frail (&gt or equal to 10/12), based on previously established cut-offs. 150 people were accepted for transplant (53% male, 61 IQR [52-67] years, 59% had interstitial lung disease (ILD), six minute walk distance (6MWD) 341 ± 107m) of which 26% were frail. 131 (87%) underwent transplant by December 31, 2018. After adjusting for age, sex and diagnosis, frailty was associated with a lower 6-minute walk distance pre-transplant [mean difference -97 meters (95%CI (133 to -60), p<0.0001] but not with post-transplant hospital length of stay or 3 month post transplant mortality, 6MWD or gait aid use. A subset of 62 people underwent at least 6 weeks of pre-habilitation (37% male, 62 IQR [56-67] years, 60% with ILD, 21% were frail). While the 6-minute walk distance did not change (362 ± 86 vs. 356 ± 101 m, p=0.43), the total SPPB score increased (pre: 11 [10-12) vs. post: 12 [11-12], p=0.01). Improvement occurred in the sit to stand component (pre: 11.42 ± 4.4 vs. post: 9.86 ± 2.8 seconds, p=0.007). A quarter of lung transplant candidates in this cohort exhibited phenotypic frailty at the time of transplant assessment. A SPPB score of &lt 10 at transplant assessment was associated with decreased exercise capacity pre-transplant but not with early post-transplant outcomes. The SPPB score increased after six weeks of pre-habilitation, which may be reflected by an increase in lower extremity strength.