ArticleJournal of the American Geriatrics Society2019
A Practical Two-Stage Frailty Assessment for Older Adults Undergoing Aortic Valve Replacement.
Article in Journal of the American Geriatrics Society, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05166863 (Physical Performance Testing and Frailty in Prediction of Early Postoperative Course After Cardiac Surgery), which is not on this map. Cited by 11 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Physical Performance Testing and Frailty in Prediction of Early Postoperative Course After Cardiac Surgery
Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it, 32 citations in OpenAlex.
- Frailty as a Predictor of Postoperative Outcomes in Invasive Cardiac Surgery: A Systematic Review of Literature.The Journal of cardiovascular nursingPooled it
- Influence of Frailty Syndrome on Outcomes of Cardiovascular Surgery in Elderly Patients.Brazilian journal of cardiovascular surgery · 2025Article
- Frailty in Cardiac Surgery-Assessment Tools, Impact on Outcomes, and Optimisation Strategies: A Narrative Review.Journal of cardiovascular development and disease · 2025Review
- A Comprehensive Geriatric Workup and Frailty Assessment in Older Patients with Severe Aortic Stenosis.Journal of clinical medicine · 2024Review
- Depression and Malnutrition for Prediction of Mortality after Transcatheter Aortic Valve Replacement: A Registry Study of a Tertiary Referral Hospital.Diagnostics (Basel, Switzerland) · 2023Article
- Transcatheter aortic valve implantation and frailty.Cardiovascular intervention and therapeutics · 2022Review
- 2021 ESC/EACTS Guidelines for the management of valvular heart disease.EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology · 2022Article
- Frailty and hospitalization-associated disability after pneumonia: A prospective cohort study.BMC geriatrics · 2021Article
- Evolution of Basic Activities of Daily Living Function in Older Patients One Year After Transcatheter Aortic Valve Implantation.Journal of the American Geriatrics Society · 2021Article
- Comparative utility of frailty to a general prognostic score in identifying patients at risk for poor outcomes after aortic valve replacement.BMC geriatrics · 2020Article
- Transcatheter aortic valve replacement over age 90: Risks vs benefits.Clinical cardiology · 2020Review
Corrections and comments
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Authors and funding
9 authors at 4 institutions in 2 countries.
Funding
Abstract
objectivesDespite evidence, frailty is not routinely assessed before cardiac surgery. We compared five brief frailty tests for predicting poor outcomes after aortic valve replacement and evaluated a strategy of performing comprehensive geriatric assessment (CGA) in screen-positive patients.
designProspective cohort study.
settingA single academic center.
participantsPatients undergoing surgical aortic valve replacement (SAVR) (n = 91; mean age = 77.8 y) or transcatheter aortic valve replacement (TAVR) (n = 137; mean age = 84.5 y) from February 2014 to June 2017. MEASUREMENTS: Brief frailty tests (Fatigue, Resistance, Ambulation, Illness, and Loss of weight [FRAIL] scale; Clinical Frailty Scale; grip strength; gait speed; and chair rise) and a deficit-accumulation frailty index based on CGA (CGA-FI) were measured at baseline. A composite of death or functional decline and severe symptoms at 6 months was assessed.
resultsThe outcome occurred in 8.8% (n = 8) after SAVR and 24.8% (n = 34) after TAVR. The chair rise test showed the highest discrimination in the SAVR (C statistic = .76) and TAVR cohorts (C statistic = .63). When the chair rise test was chosen as a screening test (≥17 s for SAVR and ≥23 s for TAVR), the incidence of outcome for screen-negative patients, screen-positive patients with CGA-FI of .34 or lower, and screen-positive patients with CGA-FI higher than .34 were 1.9% (n = 1/54), 5.3% (n = 1/19), and 33.3% (n = 6/18) after SAVR, respectively, and 15.0% (n = 9/60), 14.3% (n = 3/21), and 38.3% (n = 22/56) after TAVR, respectively. Compared with routinely performing CGA, targeting CGA to screen-positive patients would result in 54 fewer CGAs, without compromising sensitivity (routine vs targeted: .75 vs .75; P = 1.00) and specificity (.84 vs .86; P = 1.00) in the SAVR cohort; and 60 fewer CGAs with lower sensitivity (.82 vs.65; P = .03) and higher specificity (.50 vs .67; P < .01) in the TAVR cohort.
conclusionsThe chair rise test with targeted CGA may be a practical strategy to identify older patients at high risk for mortality and poor recovery after SAVR and TAVR in whom individualized care management should be considered. J Am Geriatr Soc 67:2031-2037, 2019.
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