Long term association between frailty and survival in patients with pleural disease: a cohort study protocol

Barton, Eleanor; Carter, Ben; Verduri, Alessia; Hughes, Jessica; Hewitt, Jonathan; Maskell, Nick A

doi:10.1101/2023.02.06.23285492

Cited by 2 publications

(2 citation statements)

References 19 publications

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“…Preliminary patient and public involvement discussions have been held at Southmead Hospital in Bristol (UK) after the beginning of our study exploring the rst association between frailty and pleural disease. [10] We asked a group of patients with different pleural disease their thoughts about the project. Overall, they were all positive about the research project and felt that it would bene t patient care in the future, particularly complex patients living with frailty.…”

Section: Patient and Public Involvementmentioning

confidence: 99%

“…An observational study of more than 600 patients to establish the rst association between frailty and pleural disease is ongoing. [10] The use of a frailty model to measure frailty status will be a new diagnostic tool in clinical practice that will improve the care of this group of patients. Health care professionals will be able to triage patient outcomes far better and improve the quality of life in frail patients with pleural disease.…”

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confidence: 99%

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The effect of frailty in pleural disease using the SAIL Databank: a study protocol.

Verduri

Carter

Barton

et al. 2023

Preprint

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Background Frailty can impact on patient care and its assessment may improve patient management and clinical outcomes. Pleural disease is common and associated with increased mortality and symptoms, but prediction of outcomes is limited and there is currently no evidence available on the relationship between frailty and outcomes in these patients. This protocol describes an observational study which sets out to assess whether frailty correlates with survival and morbidity in patients with malignant or non-malignant pleural disease. Methods Participants with a first episode of pleural disease after 1st January 2005 will be identified from the SAIL Databank using ICD-10 read codes. The electronic frailty index (eFI), included within the databank and measured at the time of first diagnosis of pleural disease, will provide stratification of patients by frailty status. Baseline data collection will also include: patient demographics, presence of comorbidities, smoking status, date of death. The eFI will be correlated with clinical outcomes, including survival, index hospitalisation, length of stay, readmissions, total number of hospitalisations. Our primary analysis will be all-cause mortality by eFI, adjusted for age (≤ 64, 65–74, 75–84, and ≥ 85), sex, ethnicity, deprivation score, smoking status, Charlson Comorbidity Index. The secondary analyses will be pleural disease-specific mortality, time to first hospital admission (all-cause and disease-specific), total length of stay, and readmissions. All analyses will be presented as crude and adjusted HR and OR with associated 95% CIs and p values. Discussion The aim of this study is to collect targeted data from a large dataset of subjects with a wide range of pleural disease and provide first data of size reviewing the link between frailty and pleural disease. The eFI can be a potential tool to guide clinical decision making in pleural disease. Trial registration Retrospectively registered.

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Section: Patient and Public Involvementmentioning

confidence: 99%

mentioning

confidence: 99%

The effect of frailty in pleural disease using the SAIL Databank: a study protocol.

Verduri

Carter

Barton

et al. 2023

Preprint

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The association between frailty and survival in patients with pleural disease: a retrospective cohort study

Barton,

Verduri,

Carter

et al. 2024

BMC Pulm Med

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Background There are currently no data on the relationship between frailty and mortality in pleural disease. Understanding the relationship between frailty and outcomes is increasingly important for clinicians to guide decisions regarding investigation and management. This study aims to explore the relationship between all-cause mortality and frailty status in patients with pleural disease. Methods In this retrospective analysis of a prospectively collected observational cohort study, outpatients presenting to the pleural service at a tertiary centre in Bristol, UK with a radiologically confirmed, undiagnosed pleural effusion underwent comprehensive assessment and were assigned a final diagnosis at 12 months. The modified frailty index (mFI) was calculated and participants classified as frail (mFI ≥ 0.4) or not frail (mFI ≤ 0.2). Results 676 participants were included from 3rd March 2008 to 29th December 2020. The median time to mortality was 490 days (IQR 161–1595). A positive association was found between 12-month mortality and frailty (aHR = 1.72, 95% CI 1.02–2.76, p = 0.025) and age ≥ 80 (aHR = 1.80, 95% CI 1.24–2.62, p = 0.002). Subgroup analyses found a stronger association between 12-month mortality and frailty in benign disease (aHR = 4.36, 95% CI 2.17–8.77, p < 0.0001) than in all pleural disease. Malignancy irrespective of frailty status was associated with an increase in all-cause mortality (aHR = 10.40, 95% CI 6.01–18.01, p < 0.0001). Conclusion This is the first study evaluating the relationship between frailty and outcomes in pleural disease. Our data demonstrates a strong association between frailty and 12-month mortality in this cohort. A malignant diagnosis is an independent predictor of 12-month mortality, irrespective of frailty status. Frailty was also strongly associated with 12-month mortality in patients with a benign underlying cause for their pleural disease. This has clinical relevance for pleural physicians; evaluating patients’ frailty status and its impact on mortality can guide clinicians in assessing suitability for invasive investigation and management. Trial registration This study is registered with the Health Research Authority (REC reference 08/H0102/11) and the NIHR Portfolio (Study ID 8960).

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Long term association between frailty and survival in patients with pleural disease: a cohort study protocol

Cited by 2 publications

References 19 publications

The effect of frailty in pleural disease using the SAIL Databank: a study protocol.

The effect of frailty in pleural disease using the SAIL Databank: a study protocol.

The association between frailty and survival in patients with pleural disease: a retrospective cohort study

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