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Clinical Frailty Scale as a predictor of adverse outcomes following aortic valve replacement: a systematic review and meta-analysis.

dc.contributor.authorPrendiville, Tadhg
dc.contributor.authorLeahy, Aoife
dc.contributor.authorGabr, Ahmed
dc.contributor.authorAhmad, Fayeza
dc.contributor.authorAfilalo, Jonathan
dc.contributor.authorMartin, Glen Philip
dc.contributor.authorMamas, Mamas
dc.contributor.authorCasserly, Ivan P
dc.contributor.authorMohamed, Abdirahman
dc.contributor.authorSaleh, Anastasia
dc.contributor.authorShanahan, Elaine
dc.contributor.authorO'Connor, Margaret
dc.contributor.authorGalvin, Rose
dc.date.accessioned2024-12-18T15:20:06Z
dc.date.available2024-12-18T15:20:06Z
dc.identifier.issn2053-3624
dc.identifier.pmid37567604
dc.identifier.doi10.1136/openhrt-2023-002354
dc.identifier.urihttp://hdl.handle.net/10147/643788
dc.descriptionObjectives Assessment of frailty prior to aortic valve intervention is recommended in European and North American valvular heart disease guidelines. However, there is a lack of consensus on how it is best measured. The Clinical Frailty Scale (CFS) is a well-validated measure of frailty that is relatively quick to calculate. This meta-analysis sought to examine whether the CFS predicts mortality and morbidity following either transcatheter aortic valve implantation (TAVI) or surgical aortic valve replacement (SAVR). Methods Nine electronic databases were searched systematically for data on clinical outcomes post-TAVI/SAVR, where patients had undergone preoperative frailty assessment using the CFS. The primary endpoint was 12-month mortality. TAVI and SAVR data were assessed and reported separately. For each individual study, the incidence of adverse outcomes was extracted according to a CFS score of 5–9 (ie, frail) versus 1–4 (ie, non-frail), with meta-analysis performed using a random effects model. Results Of 2612 records screened, nine were included in the review (five TAVI, three SAVR and one which included both interventions). Among 4923 TAVI patients, meta-analysis showed 12-month mortality rates of 19.1% for the frail cohort versus 9.8% for the non-frail cohort (RR 2.53 (1.63 to 3.95), p<0.001, I2=83%). For the smaller cohort of SAVR patients (n=454), mortality rates were 20.3% versus 3.9% for the frail and non-frail cohorts, respectively (RR 5.08 (2.31 to 11.15), p<0.001, I2=5%). Conclusions Frailty, as determined by the CFS, was associated with an increased mortality risk in the 12 months following either TAVI or SAVR. These data would support its use in the preoperative assessment of elderly patients undergoing aortic valve interventions.en_US
dc.language.isoenen_US
dc.rights© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
dc.rightsAttribution-NonCommercial 4.0 International*
dc.rights.urihttp://creativecommons.org/licenses/by-nc/4.0/*
dc.subjectaortic valve stenosisen_US
dc.subjectHeart Valve Prosthesis Implantationen_US
dc.subjectTranscatheter Aortic Valve Replacementen_US
dc.titleClinical Frailty Scale as a predictor of adverse outcomes following aortic valve replacement: a systematic review and meta-analysis.en_US
dc.typeArticleen_US
dc.typeOtheren_US
dc.identifier.journalOpen hearten_US
dc.source.journaltitleOpen heart
dc.source.volume10
dc.source.issue2
refterms.dateFOA2024-12-18T15:20:08Z
dc.source.countryEngland


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© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
Except where otherwise noted, this item's license is described as © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.