{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T16:04:17Z","timestamp":1788365057292,"version":"build-2803163510"},"reference-count":39,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"21","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2024,11,5]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">End\u2010stage kidney disease (ESKD) is commonly associated with critical limb\u2010threatening ischemia (CLTI) and frailty. Yet there are no specific tools to predict outcomes of CLTI in ESKD, particularly those that incorporate frailty. We aimed to assess the utility of the medical record\u2013based Hospital Frailty Risk (HFR) score in predicting outcomes of CLTI in ESKD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      We identified patients with ESKD diagnosed with CLTI from the US Renal Data System from 2015 to 2018. These patients were categorized into 3 frailty risk groups on the basis of their HFR scores: low (&lt;5), intermediate (5\u201310), high\u2010risk (&gt;10), and on the basis of whether they underwent revascularization (endovascular revascularization [ER]\/surgical revascularization [SR]) or not (no revascularization). Primary outcomes of interest included in\u2010hospital composite of death or major amputation and in\u2010hospital death. We included 49\u2009454 eligible patients, with ER\/SR cohort including 19.8% (n=9777). A total of 88.4% (ER\/SR) and 90.0% (no revascularization) were frail on the HFR scale. We found a nonlinear association between HFR score and in\u2010hospital adverse outcomes. In both cohorts, intermediate and high\u2010risk HFR scores were associated with greater risk of in\u2010hospital death (high\u2010risk, ER\/SR: odds ratio, 2.7 [95% CI, 1.6\u20134.8];\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.0001; no revascularization: odds ratio, 7.8 [95% CI, 5.3\u201311.6];\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.01) and composite of in\u2010hospital major amputation or death (high\u2010risk, ER\/SR: odds ratio, 2.4 [95% CI, 1.9\u20133.1];\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.0001; no revascularization: odds ratio, 1.7 [95% CI, 1.5\u20131.9];\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.0001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">The HFR score can predict risk of in\u2010hospital death and composite of\u00a0death or major amputation in patients with ESKD and CLTI. Further data are needed to determine the utility of the HFR score in this population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.124.036963","type":"journal-article","created":{"date-parts":[[2024,11,4]],"date-time":"2024-11-04T05:55:19Z","timestamp":1730699719000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Prognostic Value of Hospital Frailty Risk Score and Clinical Outcomes in Critical Limb\u2010Threatening Ischemia and End\u2010Stage Kidney Disease"],"prefix":"10.1161","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5389-5878","authenticated-orcid":false,"given":"Monil","family":"Majmundar","sequence":"first","affiliation":[{"name":"University of Kansas Medical Center","place":["Kansas City, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6883-5686","authenticated-orcid":false,"given":"Wan\u2010Chi","family":"Chan","sequence":"additional","affiliation":[{"name":"University of Kansas Medical Center","place":["Kansas City, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4363-1550","authenticated-orcid":false,"given":"Vivek","family":"Bhat","sequence":"additional","affiliation":[{"name":"SUNY Upstate Medical University","place":["Syracuse, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2712-0670","authenticated-orcid":false,"given":"Kunal N.","family":"Patel","sequence":"additional","affiliation":[{"name":"University of Kansas Medical Center","place":["Kansas City, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5144-5363","authenticated-orcid":false,"given":"Kirk A.","family":"Hance","sequence":"additional","affiliation":[{"name":"University of Kansas Medical Center","place":["Kansas City, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georges","family":"Hajj","sequence":"additional","affiliation":[{"name":"University of Kansas Medical Center","place":["Kansas City, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5235-325X","authenticated-orcid":false,"given":"Axel","family":"Thors","sequence":"additional","affiliation":[{"name":"University of Kansas Medical Center","place":["Kansas City, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2440-9033","authenticated-orcid":false,"given":"Kamal","family":"Gupta","sequence":"additional","affiliation":[{"name":"University of Kansas Medical Center","place":["Kansas City, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2019.02.016"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2021.04.029"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.29688"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2017.12.048"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)62167-9"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.13611215"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCINTERVENTIONS.118.006778"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.123.030294"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.nefroe.2021.05.008"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)30668-8"},{"key":"e_1_3_2_12_2","first-page":"2023","volume-title":"USRDS Annual Data Report: Epidemiology of Kidney Disease in the United States","author":"U.S. Renal Data System","year":"2023","unstructured":"U.S. Renal Data System . 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