Abstract 14351: Prognostic Impact of a Novel Objective Assessment System for Frailty in Patients Who Undergo Transcatheter Aortic Valve Implantation

Abstract

Background: Preprocedural assessment of frailty is often used to predict prognosis following transcatheter aortic valve implantation (TAVI). We introduced a novel scoring system, the Saiseikai Frailty Score (SFS), which contains objective indices of physical and mental ability, vitality, nutrition status and comorbidity. Methods and Results Consecutive 431 patients who underwent TAVI were prospectively enrolled. The SFS consists of 7 items; gait speed, grip strength, physical activity, body weight, fatigability, cognitive function and serum albumin levels, and the sum of abnormal items is presented as the SFS. SFS 0-1 are defined as low frailty (LF), 2-3 as intermediate frailty (IF) and 4-7 as high frailty (HF). Prognosis up to 1 year after the procedure and landmark analysis after 1yr were prospectively evaluated according to the frailty (median follow-up period 951 days). Of the 431 patients (age 85.0±4.9yrs [mean±SD], male 29.5%), 116 patients (26.9%) were categorized as LF, 197 (45.7%) as IF and 118 (27.4%) as HF. The cumulative 1-year mortality was significantly higher in the HF group than the other 2 groups (p=0.0038, log-rank test). Post 1-year landmark analysis revealed that only the LF had better prognosis than the other 2 groups (p=0.0013). The modified SFS with information of malignancy, lung and kidney function (LF 0-1, IF 2-3 and HF 4-11) clearly stratify the 3 groups in both the short- and long-term mortality (p=0.0006 and p<0.0001). Conclusions: The SFS enabled sophisticated and objective stratification of prognosis after TAVI. This novel frailty assessment system will be useful to determine the precise indication for TAVI.