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Frailty and Associated Outcomes in Patients With Vasculitis.

Sebastian E Sattui1, John Stadler2, Renee L Borchin3

  • 1S.E. Sattui, MD, Division of Rheumatology and Clinical Immunology, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania; ssattui@pitt.edu.

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Self-reported frailty is common in patients with vasculitis, affecting over 60% of individuals. Frail patients experienced more hospitalizations and disease flares, highlighting a significant risk for adverse outcomes.

Keywords:
ANCA vasculitisfrailtyquality of lifevasculitis

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Area of Science:

  • Rheumatology
  • Geriatrics
  • Public Health

Background:

  • Vasculitis encompasses a group of autoimmune diseases characterized by inflammation of blood vessels.
  • Frailty is a clinical syndrome of decreased physiological reserve, increasing vulnerability to adverse outcomes.
  • Understanding frailty prevalence and outcomes in vasculitis is crucial for patient management.

Purpose of the Study:

  • To determine the frequency of self-reported frailty in patients with vasculitis.
  • To investigate the outcomes associated with frailty in this population.

Main Methods:

  • The VascStrong study utilized an internet-based cohort of vasculitis patients.
  • Frailty was assessed using the 5-domain self-reported FRAIL scale at baseline and 1-year follow-up.
  • Outcomes included hospitalizations, infections, fractures, and disease flares; multivariable logistic regression identified associated factors.

Main Results:

  • Prevalence of prefrailty and frailty was 42.1% and 21.6%, respectively, in 328 patients.
  • The majority of patients across vasculitis types were prefrail or frail.
  • Frail patients reported worse Patient-Reported Outcomes Measurement Information System (PROMIS) scores and had more frequent hospitalizations and flares.

Conclusions:

  • Self-reported frailty and prefrailty are highly prevalent in patients with vasculitis.
  • This indicates a substantial patient subset at risk for poorer health outcomes.
  • Frailty status is dynamic, with significant transitions observed over one year.