{
  "abstract": "Pulmonary hypertension (PH) is a progressive, incurable condition characterised by remodelling of the pulmonary vasculature. It has high mortality and morbidity. Existing risk stratification in PH primarily focuses on haemodynamic, imaging and functional measures, which may not adequately account for patient vulnerability. In older patients and those with chronic conditions, frailty has become a useful indicator in predicting outcomes in cardiopulmonary disease, however its prognostic significance in PH is not well defined.We aimed to investigate the association between frailty and survival in adult patients with all forms of PH. Clinical, diagnostic and haemodynamic data were retrieved from the Sheffield ASPIRE registry. Frailty was prospectively assessed using the Clinical Frailty Scale (CFS). Survival analysis was performed using Kaplan-Meier curves and Cox proportional hazards regression, with adjustment for age, sex, PH aetiology and WHO functional class.606 patients were included (mean age 61.9, SD = 14.3; 63.2% female), with a median CFS score of 4. Multivariable Cox regression showed a graded increase in mortality risk with increasing CFS. Patients with a CFS score of 6-7 (HR = 11.30, 95% CI 4.90-26.08, p <0.001) showed had higher risk than patients with a CFS score of 4 (HR = 2.72, 95% CI 1.49-4.98, p <0.001) or 5 (HR = 4.84, 95% CI 2.53-9.23, p < 0,001). Kaplan-Meier curves also showed significantly worse survival in patients with CFS score 6-7 compared to 1-3, with estimates of 38% vs 89% survival at 3 years (log-rank p < 0.0001), see figure 1.CFS is an independent prognostic marker in patients with PH. Further work assessing its additive value to pre-existing risk stratification tools is ongoing. Kaplan-Meier analysis was used to examine differences in survival between CFS scores (measured using the Clinical Frailty Scale). The survival curve demonstrates large differences in survival outcomes between CFS score, with 6-7 having the worst survival probability and 1-3 having the best, log-rank p<0.0001.Abstract 364 Figure 1Kaplan-Meier curves showing survival by CFS score",
  "authors": [
    {
      "affiliations": [
        "National Pulmonary Hypertension Service, Sheffield Teaching Hospitals NHS Foundation Trust"
      ],
      "name": "C Nicholson"
    },
    {
      "affiliations": [
        "School of Medicine and Population Health, University of Sheffield"
      ],
      "name": "A Khan"
    },
    {
      "affiliations": [
        "School of Medicine and Population Health, University of Sheffield"
      ],
      "name": "I Armstrong"
    },
    {
      "affiliations": [
        "National Pulmonary Hypertension Service, Sheffield Teaching Hospitals NHS Foundation Trust",
        "School of Medicine and Population Health, University of Sheffield"
      ],
      "name": "A Charalampopoulos"
    },
    {
      "affiliations": [
        "National Pulmonary Hypertension Service, Sheffield Teaching Hospitals NHS Foundation Trust",
        "School of Medicine and Population Health, University of Sheffield"
      ],
      "name": "E Cerrone"
    },
    {
      "affiliations": [
        "National Pulmonary Hypertension Service, Sheffield Teaching Hospitals NHS Foundation Trust",
        "School of Medicine and Population Health, University of Sheffield"
      ],
      "name": "RA Condliffe"
    },
    {
      "affiliations": [
        "National Pulmonary Hypertension Service, Sheffield Teaching Hospitals NHS Foundation Trust"
      ],
      "name": "K Dwivedi"
    },
    {
      "affiliations": [
        "School of Medicine and Population Health, University of Sheffield"
      ],
      "name": "C Elliot"
    },
    {
      "affiliations": [
        "School of Medicine and Population Health, University of Sheffield"
      ],
      "name": "N Hamilton"
    },
    {
      "affiliations": [
        "School of Medicine and Population Health, University of Sheffield"
      ],
      "name": "J Hurdman"
    },
    {
      "affiliations": [
        "National Pulmonary Hypertension Service, Sheffield Teaching Hospitals NHS Foundation Trust",
        "School of Medicine and Population Health, University of Sheffield"
      ],
      "name": "AMK Rothman"
    },
    {
      "affiliations": [
        "National Pulmonary Hypertension Service, Sheffield Teaching Hospitals NHS Foundation Trust",
        "School of Medicine and Population Health, University of Sheffield"
      ],
      "name": "AJ Swift"
    },
    {
      "affiliations": [
        "National Pulmonary Hypertension Service, Sheffield Teaching Hospitals NHS Foundation Trust",
        "School of Medicine and Population Health, University of Sheffield"
      ],
      "name": "DG Kiely"
    },
    {
      "affiliations": [
        "National Pulmonary Hypertension Service, Sheffield Teaching Hospitals NHS Foundation Trust",
        "School of Medicine and Population Health, University of Sheffield"
      ],
      "name": "AAR Thompson"
    },
    {
      "affiliations": [
        "National Pulmonary Hypertension Service, Sheffield Teaching Hospitals NHS Foundation Trust",
        "School of Medicine and Population Health, University of Sheffield"
      ],
      "name": "A Hameed"
    }
  ],
  "title": "364 Frailty impacts survival in pulmonary hypertension: insight from the Sheffield ASPIRE registry",
  "uid": "7095b7b4-d138-556d-a851-cc3208a00a41"
}