NOVEL CARDIAC-SPECIFIC FRAILTY ASSESSMENT

https://youtu.be/WrORpBkgVtI BACKGROUND: Frailty, a clinical syndrome characterized by diminished function across multiple physiological systems, is underassessed in cardiac rehabilitation (CR) programs across the globe. Existing screening tools lack validity in the multimorbid cardiac population, leading to inaccurate estimation and missed intervention opportunities. This multi-phase project aims to establish a standardized, cardiac-specific framework for frailty identification and targeted intervention in CR. METHODS: This three-part Quality Improvement (QI) project utilized a retrospective chart review, cross-sectional analysis using chi-square, and an ongoing quasi-experimental design. RESULTS: Part I (n=260): Chart review identified a 30% prevalence of frailty in CR patients. Frail patients demonstrated significantly higher dropout rates (25% vs. 11% in fit patients). A critical gap in functional capacity tracking was noted: 59% of frail patients lacked numerical MET (metabolic equivalent of task) levels (vs. 30% of fit patients). Part II: Cross-sectional analysis identified eight health-related variables as statistically associated with frailty: heart failure, diabetes, cerebrovascular accident, pulmonary disease, chronic kidney disease, heart device use, previous percutaneous coronary intervention and previous myocardial infarct. These variables informed the cardiac history component of our novel frailty assessment algorithm. Part III: A quasi-experimental design is currently evaluating the impact of a targeted resistance intervention on functional outcomes during CR. Named “Building a Stronger Foundation”, this intervention aims to optimize exercise prescription for frail cardiac patients. This initiative addresses a critical gap in the current standard of care, as no gold-standard treatment for frailty in CR settings currently exists. CONCLUSION: Our findings demonstrate a high frailty prevalence and decreased clinical outcomes, supporting the need for a multidimensional, cardiac-specific frailty algorithm to guide personalized exercise prescription and improve adherence and functional outcomes in frail CR patients.