Table 3.
Late (≥30 days) outcomes related to frailty in included studies
| Author, year | Outcome(s) related to frailty | Adjustment | Effect estimatea | Lower 95% CI | Upper 95% CI | P-value |
|---|---|---|---|---|---|---|
| Ewe, 201020 | MACCE defined as composite of death, nonfatal stroke, heart failure, or nonfatal myocardial infarction (mean follow-up of 9.1 months) | Logistic EuroSCORE, peripheral vascular disease, previous CABG, baseline LVEF | 4.20 | 2.00 | 8.84 | <0.001 |
| Stortecky, 201235 | 1-year MACCE | Nil | 4.89 | 1.64 | 14.6 | 0.003 |
| 1-year MACCE | STS score | 4.17 | 1.37 | 12.72 | 0.01 | |
| 1-year MACCE | Logistic EuroSCORE | 4.48 | 1.48 | 13.53 | 0.01 | |
| 1-year MACCE (per unit increase in frailty index) | Nil | 1.80 | 1.33 | 2.45 | <0.001 | |
| 1-year all-cause mortality | Nil | 3.68 | 1.21 | 11.19 | 0.02 | |
| 1-year all-cause mortality | STS score | 2.93 | 0.93 | 9.24 | 0.07 | |
| 1-year all-cause mortality | Logistic EuroSCORE | 3.29 | 1.06 | 10.15 | 0.04 | |
| 1-year all-cause mortality (per unit increase in frailty index) | Nil | 1.80 | 1.31 | 2.47 | <0.001 | |
| Rodés-Cabau, 201236 | All-cause mortality (mean follow-up of 42 ± 15 months) | Atrial fibrillation, cerebrovascular disease, COPD, eGFR, pulmonary hypertension | 1.41 | 1.02 | 1.96 | 0.034 |
| Late all-cause mortality (excluding mortality within 30 days of TAVI) | Age, atrial fibrillation, COPD, eGFR | 1.52 | 1.07 | 2.17 | 0.021 | |
| Kamga, 201319 | 1-year all-cause mortality (per 1 unit increase in SHERPA score) | Unclear but likely gender, BMI, pulmonary hypertension, diabetes | 2.74 | 1.39 | 5.39 | 0.004 |
| Zahn, 201337 | 1-year mortality | Nil | 1.50 | 1.19 | 1.89 | <0.001 |
| Puls, 201438 | All-cause mortality (median follow-up of 537 days) | Age and sex | 2.67 | 1.7 | 4.3 | <0.0001 |
| Seiffert, 201439 | 1-year mortality | Age and sex | 1.41 | 1.23 | 1.63 | <0.001 |
| Debonnaire, 201541 | 1-year mortality | Nil | 1.29 | 0.80 | 2.06 | 0.29 |
| Green, 201542 | 1-year all-cause mortality (frailty dichotomized) | Nil | 2.18 | 1.27 | 3.75 | 0.005 |
| 1-year all-cause mortality (frailty dichotomized) | Stepwise inclusion of variablesb with entry/stay criteria of 0.1/0.1 and a maximum of one covariate for every 10 events | 2.5 | 1.40 | 4.35 | 0.002 | |
| 1-year all-cause mortality (per unit increase in frailty score) | Nil | 1.12 | 1.02 | 1.22 | 0.01 | |
| Poor outcome (death or poor quality of lifec) at 6 months | Stepwise inclusion of variablesb as above | 2.21 | 1.09 | 4.46 | 0.03 | |
| Poor outcome (death or poor quality of lifec) at 1 year | Stepwise inclusion of variablesb as above | 2.40 | 1.14 | 5.05 | 0.02 |
MACCE, major adverse cardiovascular and cerebral events; CABG, coronary artery bypass grafting; LVEF, left ventricular ejection fraction; COPD, chronic obstructive pulmonary disease; eGFR, estimated glomerular filtration rate; BMI, body mass index; TIA, transient ischaemic attack; STS, Society of Thoracic Surgeons.
aWhere not presented directly by authors, relative risk ratios calculated from two-by-two tables for those with and without frailty.
bCandidate variables: age, sex, body mass index, access route, STS score, diabetes, hypertension, angina, heart failure, New York Heart Association Class IV, coronary artery disease, previous coronary angioplasty, previous CABG, cerebrovascular disease, peripheral vascular disease, previous balloon aortic valvuloplasty, permanent pacemaker, renal disease, liver disease, chronic pulmonary disease, aortic valve mean gradient, ejection fraction, moderate or severe mitral regurgitation.
cPoor quality of life defined as Kansas City Cardiomyopathy Questionnaire Overall Summary score <45 or a decrease of ≥10 points on serial testing before and after TAVI.