Physical frailty in patients with systemic sclerosis

Area of Science:

• Rheumatology
• Geriatrics
• Internal Medicine

Background:

• Systemic sclerosis (SSc) is a chronic autoimmune disease causing organ fibrosis and damage.
• Patients with SSc often experience increased vulnerability to adverse outcomes, a condition known as frailty.
• Limited data exists on frailty prevalence and its clinical correlates in SSc patients.

Purpose of the Study:

• To determine the prevalence and clinical profile of the physical frailty phenotype (PFP) in SSc patients.
• To evaluate the diagnostic accuracy of the FRAIL scale, Edmonton frailty scale (EFS), and Short Physical Performance Battery (SPPB) against the PFP.

Main Methods:

• A cross-sectional study of 94 SSc patients.
• Frailty assessed using the PFP, FRAIL scale, EFS, and SPPB.
• Diagnostic accuracy evaluated using receiver operating characteristic curves with PFP as the reference standard.

Main Results:

• 35.1% of SSc patients were frail and 56.4% were pre-frail by PFP.
• FRAIL scale and EFS demonstrated excellent diagnostic accuracy (AUC > 0.82).
• PFP was associated with glucocorticoid use, GI symptoms, malnutrition, and hospitalizations.

Conclusions:

• Frailty is prevalent in SSc and associated with disability, daily activity limitations, and hospitalizations.
• The FRAIL scale shows high sensitivity and practicality for assessing frailty in SSc.
• Early identification of frailty can guide clinical management in SSc patients.