{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T11:37:01Z","timestamp":1790768221630,"version":"4.1.0"},"reference-count":63,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2023,2,17]],"date-time":"2023-02-17T00:00:00Z","timestamp":1676592000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institutes for Health Research\u2014Canada Graduate Scholarships","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Nova Scotia Graduate Scholarship"},{"DOI":"10.13039\/501100000222","name":"Heart and Stroke Foundation of Canada","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000222","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Killam Predoctoral Scholarship."},{"DOI":"10.13039\/100007670","name":"Dalhousie Medical Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007670","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,7,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>Examine the association between (1) admission frailty and (2) frailty changes during cardiac rehabilitation (CR) with 5-year outcomes (i.e. time to mortality, first hospitalization, first emergency department (ED) visit, and number of hospitalizations, hospital days, and ED visits).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>Data from patients admitted to a 12-week CR programme in Halifax, Nova Scotia, from May 2005 to April 2015 (n = 3371) were analysed. A 25-item frailty index (FI) estimated frailty levels at CR admission and completion. FI improvements were determined by calculating the difference between admission and discharge FI. CR data were linked to administrative health data to examine 5-year outcomes [due to all causes and cardiovascular diseases (CVDs)]. Cox regression, Fine\u2013Gray models, and negative binomial hurdle models were used to determine the association between FI and outcomes. On average, patients were 61.9 (SD: 10.7) years old and 74% were male. Mean admission FI scores were 0.34 (SD: 0.13), which improved by 0.07 (SD: 0.09) by CR completion. Admission FI was associated with time to mortality [HRs\/IRRs per 0.01 FI increase: all causes = 1.02(95% CI 1.01,1.04); CVD = 1.03(1.02,1.05)], hospitalization [all causes = 1.02(1.01,1.02); CVD = 1.02(1.01,1.02)], ED visit [all causes = 1.01(1.00,1.01)], and the number of hospitalizations [all causes = 1.02(95% CI 1.01,1.03); CVD = 1.02(1.00,1.04)], hospital days [all causes = 1.01(1.01,1.03)], and ED visits [all causes = 1.02(1.02,1.03)]. FI improvements during CR had a protective effect regarding time to all-cause hospitalization [0.99(0.98,0.99)] but were not associated with other outcomes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Frailty status at CR admission was related to long-term adverse outcomes. Frailty improvements during CR were associated with delayed all-cause hospitalization, in which a larger effect was associated with a greater chance of improved outcome.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/eurjpc\/zwad048","type":"journal-article","created":{"date-parts":[[2023,2,17]],"date-time":"2023-02-17T16:13:32Z","timestamp":1676650412000},"page":"807-819","source":"Crossref","is-referenced-by-count":24,"title":["Association of admission frailty and frailty changes during cardiac rehabilitation with 5-year outcomes"],"prefix":"10.1093","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0998-0485","authenticated-orcid":false,"given":"Jack","family":"Quach","sequence":"first","affiliation":[{"name":"School of Physiotherapy, Dalhousie University , 5869 University Ave, Halifax, NS B3H 4R2 , Canada"},{"name":"Division of Geriatric Medicine, Dalhousie University , 5955 Veterans Memorial Lane, Halifax, NS B3H 2E1 , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dustin Scott","family":"Kehler","sequence":"additional","affiliation":[{"name":"School of Physiotherapy, Dalhousie University , 5869 University Ave, Halifax, NS B3H 4R2 , Canada"},{"name":"Division of Geriatric Medicine, Dalhousie University , 5955 Veterans Memorial Lane, Halifax, NS B3H 2E1 , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas","family":"Giacomantonio","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Dalhousie University , 1796 Summer Street, Halifax, NS B3H 3A7 , Canada"},{"name":"Department of Medicine, Dalhousie University , 1276 South Park Street, Halifax, NS B3H 2Y9 , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caitlin","family":"McArthur","sequence":"additional","affiliation":[{"name":"School of Physiotherapy, Dalhousie University , 5869 University Ave, Halifax, NS B3H 4R2 , 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