Multidimensional Frailty and Mortality in Transcatheter Aortic Valve Implantation Patients　- Prognostic Value of the...

Frailty is a crucial factor in the prognoses of patients who undergo transcatheter aortic valve implantation (TAVI); however, comprehensive assessments of this parameter are not frequently performed in this regard. This study evaluated the prognostic value of the Kihon Checklist (KCL), which covers physical, cognitive, and social domains, for patients receiving TAVI.

We retrospectively analyzed data from 986 patients who underwent elective TAVI between May 2017 and September 2022. Frailty was classified according to the KCL as non-frail (for scores of 0-3), pre-frail (4-7), or frail (≥8). The primary outcome measure was all-cause mortality following discharge. Kaplan-Meier, Cox regression, and classification and regression tree (CART) analyses were used. Of the overall patient cohort, 47.4% were classified as frail. Over a mean follow-up period of 968±578 days, 18.1% died. Frailty was significantly associated with higher mortality (adjusted hazard ratio 1.771; 95% confidence interval 1.096-2.862; P<0.02). Impaired socialization and physical function were also found to represent independent predictors of mortality. CART identified socialization as the primary node in the risk stratification.

Preoperative frailty, as defined by the KCL, was found to be independently associated with mortality after TAVI. Social and physical domains were also found to have strong prognostic relevance in this context.