A Comparison of Self-Reported Physical Function to In-Person Frailty Assessments for the Prediction of Rehospitalizations After Kidney Transplantation

E. Lorenz¹, C. Kennedy¹, C. Schinstock¹, A. Kukla¹, D. Eton¹, H. Wadei², G. Mour³, P. Dean⁴, A. Rule¹, N. LeBrasseur¹, A. Cheville¹

¹Mayo Clinic, Rochester, MN, ²Mayo Clinic, Jacksonville, FL, ³Mayo Clinic, Scottsdale, AZ, ⁴Mayo Clinic Rochester, Rochester, MN

Meeting: 2022 American Transplant Congress

Abstract number: 222

Keywords: Kidney transplantation, Outcome, Post-operative complications, Quality of life

Topic: Clinical Science » Kidney » 35 - Kidney: Cardiovascular and Metabolic Complications

Session Information

Session Name: Kidney: Cardiovascular and Metabolic Complications II

Session Type: Rapid Fire Oral Abstract

Date: Monday, June 6, 2022

Session Time: 3:30pm-5:00pm

Presentation Time: 4:30pm-4:40pm

Location: Hynes Veterans Auditorium

*Purpose: Rehospitalizations are common after kidney transplantation (KT) and associated with increased cost, allograft failure, and death. Physical frailty as defined by Fried criteria has been associated with an increased risk of post-KT rehospitalizations but requires in-person assessment of strength and physical function (PF). The aim of this study was to examine whether self-reported PF assessed via survey can also be used to predict post-KT rehospitalization.

*Methods: We conducted a prospective cohort study involving patients undergoing KT at Mayo Clinic in Minnesota, Arizona, and Florida from 2020 to 2021. Physical frailty was defined as having 3 or more Fried criteria (decreased grip strength, slow walking speed, exhaustion, low physical activity, unintentional weight loss). Self-reported PF was assessed using the Patient-Reported Outcomes Measurement Information (PROMIS) PF 4-item short form. Physical frailty and PF assessments were performed on the same day either at the time of outpatient preoperative evaluation or hospital admission. Decreased PF was defined as a T-score < 40 according to established cut-points for at least moderately reduced PF. The risk of 30-day rehospitalizations with physical frailty or self-reported PF was estimated using logistic regression.

*Results: Our cohort consisted of 258 participants with a mean age of 54 years. Overall, 56% were male, 83% were Caucasian, and 34% received a deceased donor KT. Prior to KT, 39 participants (15%) were physically frail, and 64 (25%) reported decreased PF. Twenty-one participants (8%) were both physically frail and reported decreased PF. Sixty-two participants (24%) experienced a rehospitalization after KT. Rehospitalizations were more common in patients who were physically frail (44% vs 20%, p=0.002) or who reported decreased PF (41% vs 19%, p=0.0004). After adjusting for age, sex, race, and history of dialysis, physical frailty and decreased PF remained associated with an increased risk of rehospitalization (OR 2.2, CI 1.0-4.8, p=0.04 and OR 2.6, CI 1.3-5.1, p=0.005, respectively).

*Conclusions: Moderately to severely decreased PF prior to KT is common and prognostic for post-KT rehospitalization. Self-reported PF is a simple 4-item survey that can be administered remotely and may predict rehospitalization as well as in-person physical frailty assessments.

To cite this abstract in AMA style:

Lorenz E, Kennedy C, Schinstock C, Kukla A, Eton D, Wadei H, Mour G, Dean P, Rule A, LeBrasseur N, Cheville A. A Comparison of Self-Reported Physical Function to In-Person Frailty Assessments for the Prediction of Rehospitalizations After Kidney Transplantation [abstract]. Am J Transplant. 2022; 22 (suppl 3). https://atcmeetingabstracts.com/abstract/a-comparison-of-self-reported-physical-function-to-in-person-frailty-assessments-for-the-prediction-of-rehospitalizations-after-kidney-transplantation/. Accessed November 24, 2024.

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