ArticleJournal of geriatric cardiology : JGC2026
Frailty as a predictor of delayed discharge and 12-month mortality following transcatheter aortic valve implantation.
Article in Journal of geriatric cardiology : JGC, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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12 authors.
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Abstract
Background: Transcatheter aortic valve implantation (TAVI) is the principal treatment for aortic stenosis in older and high-risk patients. Whilst important in holistic decision making, frailty indices vary in ease of use, objectivity, and accuracy. We assess prognostic ability of the Clinical Frailty Scale (CFS) and Essential Frailty Toolset (EFT) in predicting delayed discharge and 1-year mortality following TAVI. Methods: Prospective, single centre, observational cohort study of patients undergoing TAVI at a tertiary centre in the UK from 2020-2022. Clinical characteristics, CFS, and EFT were collected pre-procedurally. Primary outcomes were length of hospital stay following TAVI and mortality at 1- year post-procedure. Generalized regression with elastic net is used to assess the additive discriminative ability of frailty scores to predict outcomes. Stepwise regression is used to identify informative outcome predictors. Results: One hundred and four patients were included with mean age 81.3 ± 5.9 years, 47% female. Median post-procedural stay length was 2 days (IQR 2.75). Use of EFT and CFS resulted in a statistically significant prediction of survival at 1 year post TAVI (EFT: ΔLogL of 2.68, ChiSq Conclusions: EFT informs decision making on survival 1-year post-TAVI, beyond conventional measures. Use of non-femoral access site and high CFS are the best predictors of delayed discharge. Surgical risk stratification scores poorly predict medium-term TAVI survival and delayed discharge.
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