ArticleClinical interventions in aging2026
Development and Validation of a Predictive Risk Score for Poor Functional Outcome After Transcatheter Aortic Valve Replacement in Elderly Patients.
Article in Clinical interventions in aging, 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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Abstract
Purpose: Despite the success of transcatheter aortic valve replacement (TAVR) for severe aortic stenosis (AS), a subset of older adults experience poor functional recovery. We aimed to develop and validate a pragmatic clinical risk score to predict poor 6-month functional outcomes in this population. Methods: We conducted a retrospective cohort study of 204 elderly patients (≥65 years, 106 males and 98 females) with severe AS who underwent TAVR at our center between March 2021 and March 2024. The primary endpoint was poor functional outcome at 6 months, defined as a composite of failure to improve left ventricular ejection fraction (LVEF) by >10% and failure to increase 6-minute walk test (6MWT) distance by >50 meters. Patients were randomly split into a training cohort (n=143) and a validation cohort (n=61). LASSO regression was used in the training cohort to identify predictors and construct the TAVR-PRO (Transcatheter Aortic Valve Replacement - Poor Recovery Outcome) risk score. Model performance was assessed using the area under the receiver operating characteristic curve (AUC) and calibration plots. A secondary endpoint of 1-year all-cause mortality was analyzed using Kaplan-Meier curves. Results: Five independent predictors were incorporated into the TAVR-PRO score: advanced age (≥80 years), Clinical Frailty Scale (CFS) >4, NT-proBNP >3000 pg/mL, coronary artery disease, and chronic kidney disease (eGFR < 45 mL/min/1.73m Conclusion: The TAVR-PRO score, based on five readily available variables, is a simple and effective tool for predicting poor functional outcomes and mortality after TAVR in older adults. This score can aid in shared decision-making, patient counseling, and identifying high-risk individuals for targeted interventions.
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