INTRODUCTION:

While frailty is thought to be common in chronic obstructive pulmonary disease (COPD), little is known about the relationship between frailty and COPD-related outcomes.

OBJECTIVE:

To explore multidimensional frailty as a severity indicator and predictor of exacerbation in COPD patients.

METHODS:

We conducted a cross-sectional study in a cohort of consenting patients followed for confirmed COPD with a history of acute exacerbation of COPD (AECOPD) at the pulmonology Department IV in Abderrahman Mami hospital, between January and December 2022. Frailty was assessed in these patients outside of an exacerbation, using Frailty scale classifying patients as "frail", "pre-frail" and "non-frail". Disease severity was assessed according to the Global Initiative on Obstructive Lung Disease (GOLD) 2022 recommendations.

RESULTS:

Our study included 108 male patients. The mean age was 66.01 ± 9.36 years. The mean body mass index (BMI) was 21.09 ± 4.94 Kg/m2. Overall, 61 (56.5%) of patients were considered frail. Frail patients were significantly more likely to be readmitted for AECOPD within 120 days ( 87.5% versus 10.7%, P<10-3) . A strong correlation was found between frailty and higher scores in the mMRC scale (r= 0.221, p=0.028), number of hospitalizations for AECOPD in the previous year (r=0.411, P<10-3), the absence of family support (r=0.354, P<10-3) and chronic respiratory failure (r=0.274, p=0.007). Remarkably, frailty improved the predictive accuracy of readmission by improving the area under the receiver operator curve (AUC).

CONCLUSION:

This study highlights that multidimensional frailty predicts the risk of early hospital readmission in patients hospitalized for AECOPD.