BG10 A brief analysis of frailty in hidradenitis suppurativa

Abstract Hidradenitis suppurativa (HS) is a chronic condition of painful scarring nodules and abscesses, with a high comorbidity burden. Frailty is a syndrome of decreased reserve, which causes disability independently of clinical disease and is associated with multimorbidity in all age groups. Fried’s widely used definition of frailty is three or more out of five indicators: weakness (reduced grip strength), slowness (gait speed), weight loss, low physical activity and exhaustion. People with one or two indicators are classified ‘pre-frail’. Prevalence of frailty and pre-frailty increases with multimorbidity, and the association of frailty with increased mortality has important implications. To date, there has been no research analysing frailty in HS. This study plans to assess frailty in HS using two validated scales – the SHARE-Frailty Instrument (SHARE-FI) and Rockwood’s Clinical Frailty Scale (CFS) – alongside demographics and comorbidities. Patients with HS at our tertiary dermatology clinic were invited to participate. Demographics, anthropometrics and SHARE-FI questions were completed by participants, with dynamometer-assessed grip strength. The researcher completed the Rockwood CFS. SHARE-FI score was then calculated using an online SHARE-FI calculator. Statistical analysis was performed using Spearman’s rank correlation to assess the strength and direction of relationships between HS severity, frailty scores and anthropometric measures. Differences in frailty across Hurley stages were evaluated using the Kruskal–Wallis H-test. Statistical significance was P < 0.05. Analyses were performed using SPSS v30. In the first month, 10 patients participated. Their median age was 33.5 years and 70% were female. Body mass index ranged from 23.6 to 47.8 kg m−2 (mean of 33.9). Six participants reported comorbidities, including polycystic ovary syndrome and malignancies. Lower weight was significantly associated with higher frailty, demonstrated by strong negative correlations (Spearman’s rank correlation) with both Rockwood CFS (rs = −0.74, P < 0.05) and SHARE-FI score (rs = −0.67, P < 0.05). Similarly, shorter stature was linked to greater frailty, with strong negative correlation observed between height and Rockwood CFS (rs = −0.72, P < 0.05). For HS severity, a moderate positive correlation was found between Hurley stage and Rockwood CFS (rs = 0.34, P = 0.24), and a weak positive association was observed between Hurley stage and SHARE-FI score (rs = 0.18, P = 0.61). This suggests that more severe HS may be associated with higher frailty scores. Neither association was statistically significant, which may reflect trends that are limited by sample size. In a group of 10 patients with HS, only four were classified as non-frail using the validated SHARE-FI. A trend of increasing HS severity and frailty was observed. These early results also indicate the burden of comorbidity in HS. This ongoing study may indicate those who are at risk of increased mortality and would benefit from targeted interventions to minimize frailty in HS.