P107 - ASSOCIATION OF FRAILTY WITH CLINICAL OUTCOMES IN PATIENTS RECEIVING PRIMARY PREVENTION IMPLANTABLE CARDIOVERTER DEFIBRILLATORS: A PROSPECTIVE COHORT STUDY

Background: Frailty predisposes individuals to morbidity and mortality. Increasing numbers of elderly and comorbid individuals are undergoing primary prevention implantable cardioverter-defibrillator (ICD) device placement. Little is known about the association of frailty with post device implantation outcomes.

METHODS AND RESULTS: We conducted a single center, prospective cohort study of 71 patients who underwent primary prevention ICD insertion and who had their baseline frailty status assessed using the Fried index. Participants were followed for a median period of 7.8 years.

The mean age (±SD) was 70.6 ± 4.5 years. 12 (17%) patients met the criteria for frailty. 23 (33%) patients received cardiac resynchronization therapy. Frailty was associated with a significantly higher incidence of mortality (HR [95% CI]; 3.9 [1.2 – 12.1]), ED visits (2.7 [1.1 – 6.7]), and hospitalizations (2.8 [1.1 – 7.6]). Within the non-frail cohort, there was no association between Fried frailty scores and adverse outcomes. None of the frail patients received appropriate shock therapy.

Conclusion: Among primary prevention ICD recipients, frailty is associated with worse mortality and morbidity. Clinicians should consider frailty when discussing risks and benefits with this patient population.