Frailty Phenotype and Deficit Accumulation Frailty Index in Predicting Recovery After Transcatheter and Surgical Aortic Valve Replacement

The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
Sandra ShiDae Hyun Kim

Abstract

Frailty phenotype and deficit-accumulation frailty index (FI) are widely used measures of frailty. Their performance in predicting recovery after surgical aortic valve replacement (SAVR) and transcatheter aortic valve replacement (TAVR) has not been compared. Patients undergoing SAVR (n=91) or TAVR (n=137) at an academic medical center were prospectively assessed for frailty phenotype and FI. Outcomes were death or poor recovery, defined as a decline in ability to perform 22 daily activities and New York Heart Association class 3 or 4 at 6 months after surgery. The predictive ability of frailty phenotype vs FI and their additive value to a traditional surgical risk model were evaluated using C-statistics, net reclassification improvement (NRI), and integrated discrimination improvement (IDI). TAVR patients had higher prevalence of phenotypic frailty (85% vs 38%, p<0.001) and greater mean FI (0.37 vs 0.24, p<0.001) than SAVR patients. In the overall cohort, FI had a higher C-statistic than frailty phenotype (0.74 vs 0.63, p=0.01) for predicting death or poor recovery. Adding FI to the traditional model improved prediction (NRI, 26.4%, p=0.02; IDI, 7.7%, p<0.001), while adding phenotypic frailty did not (NRI, 4.0%, p=0.70; IDI, 1...Continue Reading

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Citations

Mar 13, 2019·Anaesthesia·J R Falvey, L E Ferrante
Apr 11, 2020·Journal of the American Geriatrics Society·Sandra M ShiDae Hyun Kim
Feb 20, 2020·Journal of General Internal Medicine·Sandra M ShiDae Hyun Kim
Nov 7, 2020·Journal of the American Geriatrics Society·Dominic BertschiAndreas W Schoenenberger
Apr 15, 2021·Current Opinion in Anaesthesiology·Ibukunoluwa Adeleke, Jeanna Blitz
Jun 5, 2021·Current Geriatrics Reports·Alyssa D Stookey, Leslie I Katzel

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