Associação da fragilidade com variáveis clínicas e demográficas e com a qualidade de vida em pacientes em hemodiálise

Abstract

Despite studies showing that frailty is a highly prevalent condition in hemodialysis patients, few have been conducted in Brazil, especially with a larger sample size. The identification of the frailty phenotype, as well as the factors associated with these conditions, can contribute to the implementation of preventive and supportive measures in planning care and rehabilitation programs for this population. Objectives: To investigate the prevalence of the frailty phenotype and evaluate its association with clinical and sociodemographic data and quality of life in hemodialysis patients. Methods: A cross-sectional and multicenter study conducted with adult patients undergoing hemodialysis for a minimum period of three months. Frailty was assessed by Fried et al. (2001) phenotype, with exhaustion measured by the vitality domain of the SF-36 questionnaire and physical activity level by the Human Activity Profile questionnaire. Quality of life was assessed using the eight domains of the SF-36 questionnaire. ANOVA and chi-square tests were used for comparisons among the frail, prefrail, and non-frail groups. The association between frailty classifications and other variables was evaluated by a multivariate multinomial logistic regression analysis and subsequent adjustment for potential confounders. A p-value <0.05 was considered statistically significant. Results: A total of 199 hemodialysis patients with a mean age of 59.1 ± 12.5 years were included, with 41.2% female. The prevalences of frailty and prefrailty were 17.6% and 54.8%, respectively. Exhaustion and low physical activity level were the phenotype components that contributed most to frailty compared to others, with prevalences of 83% and 97%, respectively. The absence of a history of falls and higher scores on the mental health, physical functioning, and role physical domains of the SF-36 questionnaire decreased the chance of patients being classified as frail. Higher scores on the physical functioning and role physical domains decreased the chances of patients being classified as prefrail. These associations remained statistically significant after adjustment for potential confounders. Conclusion: The prevalence of prefrailty was approximately three times higher than that of frailty in hemodialysis patients. The domains of physical functioning and role physical of the SF-36 were associated with prefrailty and frailty, and a history of falls was associated with frailty in these patients.