Association of Frailty Factors, Especially Handgrip Strength, With One-Year Clinical Prognosis Following...

Frailty is an important determinant of prognosis in older patients undergoing transcatheter aortic valve implantation (TAVI). However, because frailty is a multidimensional construct, the specific components that most strongly influence long-term outcomes remain unclear. This study aimed to identify the preoperative frailty components associated with one-year composite outcomes after TAVI.

This retrospective cohort study included 123 patients who underwent TAVI. Preoperative frailty was assessed using the Clinical Frailty Scale (CFS), and its components were evaluated across physical (handgrip strength and short physical performance battery (SPPB)) and nutritional (serum albumin) domains. Univariate and multivariate Cox proportional hazards analyses were performed using multivariate models adjusted for age and sex. During the one-year follow-up period, 32 events (all-cause death or rehospitalization) occurred. In the univariate analysis, preoperative frailty, defined as a Clinical Frailty Scale (CFS) score ≥ 5 (hazard ratio (HR): 2.11, p=0.032), and handgrip strength (HR: 0.95, p=0.034) were significantly associated with the outcomes. In the multivariate analysis, only handgrip strength remained an independent predictor (HR: 0.93, 95% confidence interval (CI): 0.88-0.98, p=0.006). Receiver operating characteristic (ROC) analysis identified an exploratory cutoff value of 13.3 kg (area under the curve=0.622), and Kaplan-Meier analysis showed significantly lower event-free survival in patients with low handgrip strength.

Preoperative handgrip strength was an independent predictor of the one-year post-TAVI outcomes. It may serve as a practical tool for risk stratification and individualized rehabilitation planning.