Eyeball Test for the Assessment of Frailty in Elderly Patients in Electrophysiology Department: A Prospective Study

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INTRODUCTION: Frailty is a syndrome characterized by increased vulnerability to stressful events due to diminished metabolic, neuromuscular, and functional reserves. It has been associated with poor outcomes in patients with cardiovascular diseases. This study compares the eyeball test and the Fried test (considered the "gold standard") for frailty assessment in elderly patients in an electrophysiology clinic. METHODS: This prospective study included stable patients aged 75 years and older who were assessed in an electrophysiology clinic. Frailty assessment was conducted using both the Eyeball and Fried tests. Patients were first evaluated by an electrophysiologist who used the Eyeball test to grade frailty on a Fried-type scale (1-5, with frailty defined as a score ≥3). Subsequently, each patient underwent objective measurements of frailty using the Fried test. RESULTS: A total of 201 patients with a median age of 82 ± 7 years were included in the study, with 62% being males. According to the Fried test, 81 (40%) patients were classified as frail. The majority of frail patients were over 80 years old. The eyeball test demonstrated an 88.9% sensitivity and a 78.3% specificity in diagnosing frailty. Accordingly, positive and negative predictive values were 73.5% and 91.2%, respectively. CONCLUSION: The eyeball test is highly accurate for ruling out frailty in elderly outpatients in an electrophysiology clinic. However, when frailty is suspected based on the eyeball test, an additional objective test, such as the Fried test, should be used to confirm the diagnosis.

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