ObjectivesFrailty is associated with increased morbidity and mortality in chronic lung disease, but its prognosis has not been evaluated in pulmonary arterial hypertension (PAH). This study aimed to assess: (1) impact of frailty on hospital length of stay (LOS) and health-care utilization in PAH; (2) association of frailty with 1-year post-discharge outcomes.MethodsRetrospective, single-centered cohort study of consecutive PAH patients admitted non-electively (January 2009-December 2018), predominantly for right heart failure (57%). Frailty was defined as ≥ 0.25 using a cumulative deficits frailty index. Disease characteristics, hospital factors, and mortality were compared using univariate analysis and multivariable regression, adjusting for age and sex.Results44/96 (46%) PAH patients were frail. Frailty was associated with older age, greater comorbidities, and lower six-minute walk distance pre-admission (p < 0.05). Frail patients had a longer hospital LOS (4 days 95% (0.4-6.3), p = 0.04) and were more likely to receive social work consultation (36% vs 13%, p = 0.01), independent of age and sex. There were no adjusted differences (frail vs non-frail) in hospital mortality (OR:1.01 95% (0.28-3.72) or 12-months mortality post-discharge (HR:1.26 95% (0.48-3.29).ConclusionFrailty was associated with greater hospital LOS and interdisciplinary support, but not 1-year mortality. Future studies should explore whether alternative frailty models may be more informative of longer-term PAH outcomes.
Keywords: frailty; hospitalization; pulmonary hypertension.