Frailty assessment in patients with systemic sclerosis.

Objectives

To evaluate the prevalence of frailty, a clinical syndrome characterised by reduced physiological reserve which exposes affected individuals to the worst consequences of acute clinical episodes, in SSc patients, and to identify associated demographic and clinical factors.

Methods

Frailty, comorbidities, SSc-related-activity, -organ damage and -overall patient-reported impact were assessed in 169 consecutive outpatients with SSc aged over 60 years by Primary Care Frailty Index (PC-FI), age-adjusted Charlson Comorbidity index (CCI), revised EUSTAR activity index, Scleroderma Clinical Trials Consortium Damage Index (SCTC-DI), and Sclero-ID, respectively. Information and data on hospitalisations were recorded during follow-up visits, scheduled according to clinical necessity, in 85 patients.

Results

Frailty was observed in 51.3% of patients, with 31.9% classified as mildly frail, 10.7% as moderately frail, and 7.7% as severely frail. Frail SSc patients, as compared with non-Frail, were older, had a longer disease duration, higher CCI, SCTC-DI, Sclero-ID and exhibited more severe SSc complications. Multivariate analysis identified that disease duration and SSc-related organ damage as independent factors associated with PC-FI scores. Patients who died or required hospitalisation during follow-up were older, with higher PC-FI and CCI than the other SSc patients, though their SSc disease activity and damage did not differ significantly.

Conclusions

Over half of SSc patients exhibited frailty, which correlated with both SSc-related organ damage and comorbidities. PC-FI appears to predict death and hospitalisations in SSc patients, highlighting frailty assessment as a potential tool for health program planning.