Author + information
- M. Chadi Alraies1,
- Homam Moussa Pacha2,
- Elizabeth Bond1,
- Kyle Buchanan3,
- Toby Rogers1,
- Edward Koifman1,
- Arie Steinvil4,
- Petros Okubagzi1,
- Linzhi Xu1,
- Rebecca Torguson3,
- Itsik Ben-Dor5,
- Augusto Pichard3,
- Lowell Satler3 and
- Ron Waksman5
- 1MedStar Washington Hospital Center, Washington, District of Columbia, United States
- 2Medstar Washingtion Hospital Center, Silver Spring, Maryland, United States
- 3Washington Hospital Center, Washington, District of Columbia, United States
- 4Medstar Washington Hospital center, Washington DC, USA, Washington, District of Columbia, United States
- 5Medstar Washington Hospital Center, Washington, District of Columbia, United States
Society of Thoracic surgery (STS) score is used to determine transcatheter aortic valve replacement (TAVR) procedure risk. We aim to determine value of frailty index in predicting mortality at 30 days and one-year.
The study population included 544 consecutive TAVR patients who had full frailty assessment and STS score calculation at time of procedure. Frailty defined by the presence of any 3 of the following 5 criteria: algorithm defined grip strength and 5-meter walking tests, BMI <20kg/m2, Katz ADL ≤4/6, serum Albumin<3.5g/dL. Patients were divided into 4 groups based on frailty index and STS score; non-frail and STS < 8, non-frail and STS > 8, frail and STS < 8, frail and STS > 8. Mortality estimate was done using Kaplan Meier analysis and log-rank test.
Based on Frailty definition, 242 patients were frail, while 302 patients were not frail. STS score was higher in frail group compared to non-frail group (mean STS 8.82 ± 6.04 vs 6.2 ± 3.56, P <.001). Patients who have STS > 8 and are frail had heist mortality at 30-day and 1-year compared with those who have STS > 8 and are non-frail, STS < 8 and are frail, and STS < 8 and are non-frail (p=0.0005).
Frailty status is associated with higher mortality at 30-day and 1-year compared with STS score. Therefore, higher weight should be given to the frailty score as a correlate to outcome.
OTHER: Quality, Guidelines and Appropriateness Criteria