1247 - Frailty Characteristics of Patients Undergoing Assessment for Heart Transplantation

A greater proportion of inpatient candidates were frail, with 32% meeting frailty criteria by mFFP, compared to 12.5% of outpatients. Outpatients performed better on objective aspects of the mFFP (gait speed and grip strength), but symptom burden was similar across both groups, with approximately one-quarter of patients in each setting endorsing exhaustion, poor appetite, and low physical activity.

SPPB scores among inpatients ranged from 0–12, while outpatient scores ranged from 5–12. The most common abnormality was slow gait speed, though impaired chair stands were also frequent. As defined by the SPPB, not being frail was correlated with being listed for transplant, whereas the mFFP score did not predict listing status. All patients received a multimodal prehabilitation plan aimed at improving frailty.

Conclusions:

A significant proportion of patients undergoing evaluation for heart transplantation exhibit physical frailty and high symptom burden. Common deficits shown in frailty assessments included slowed gait speed and impaired chair stands, particularly among inpatients. Symptoms of poor appetite, exhaustion, and low physical activity were common in heart transplant candidates regardless of setting. An individualized prehabilitation plan, based on frailty assessments and clinical judgment, has the potential to mitigate these risk factors and improve the likelihood of being listed for transplantation in the future.