Quality of life and frailty: an important issue for elderly patients with an implanted pacemaker.

Abstract

Abstract Funding Acknowledgements Type of funding sources: None. Background Quality of life (QoL) and Frailty Syndrome (FS) are increasingly considered in the clinical evaluation after invasive cardiac procedures, such as pacemaker implantation in the elderly. Purpose The aim of the study was to report on the baseline to follow-up changes in QoL and FS in patients following pacemaker implantation. Methods The population of the study comprised 101 elderly patients (≥65 y/o) who were qualified for pacemaker implantation. The medical record analysis and self-administered questionnaire were used twice: before the implantation (Cardiology Department) and after 6 months (outpatient clinic). The following instruments were used: sociodemographic and clinical data, WHO Quality of Life and the Tilburg Frailty Indicator (TFI). Results The mean age of the participants (54 men) was 76.44 ± 6,92. The 6-month analysis showed that QoL scores in all domains were significantly higher than before implantation, respectively (p<0.001): physical domain (SD = 15.72 vs. SD = 21.17; T = 4810.50, z = - 8.154) psychological domain (SD = 27.55 vs. SD = 23.14; T = 4553.50, z = - 8.135), social domain (SD = 12.10 vs. SD = 17.36; T = 2396.50, z = - 6.776), and environmental domain (SD = 13.00 vs. SD = 16.80; T = 4414.00, z = - 7.932). The analysis of the FS showed that all FS components decreased compared to the subjects' score at baseline measurement (p<0.001), respectively: physical component level: SD = 1.42 vs. SD = 1.53; T = 3916, z = -9.381), psychological components (SD = 0.67 vs. SD = 0.94; T = 990, z = - 6.633), social components (SD = 0.83 vs. SD = 0.89; T = 300, z = - 4.899). The additional analysis revealed that age (in all domains) and FS (only in the physical domain) were predictors of better QoL. The results indicate that as age increases by one year, post-implantation QoL decreases by 0.4 points, B = -0.40; β = -0.18 (physical domain), by 0.89 points, B = -0.89; β = -0.22 (psychological domain), by 0.55 points, B = -0.55; β = -0.32 (social domain), and by 0.44 points, B = -0.44; β = -0.25 (environmental domain). In contrast, greater severity of FS symptoms before implantation is a significant predictor of lower QoL after implantation, B = -0.99; β = -0.40. Conclusion(s) The assessment of QoL and FS, in addition to the clinical assessment, should be performed in elderly patients qualified for pacemaker implantation. The results indicate that pacemaker implantation is an important factor in improving the QoL and reducing the severity of physical component of FS. Appropriate assessment may be helpful in optimizing the therapeutic management in terms of prognostic assessment and the risk of hospitalization.