Preoperative frailty was not significantly associated with acute kidney injury within 7 days after transcatheter aortic valve implantation compared to non-frail patients (12.7% vs 8.8%, OR 1.42).
Cohort (n=781)
Yes
Does preoperative frailty increase the risk of acute kidney injury and resource utilization in patients aged 65 years or older undergoing TAVI?
Preoperative frailty in older patients undergoing TAVI is associated with prolonged hospital length of stay, though not significantly associated with an increased risk of acute kidney injury.
Odds Ratio: 1.42 (95% CI 0.83–2.45)
Absolute Event Rate: 12.7% vs 8.8%
p-value: p=0.20
Patients with severe aortic stenosis undergoing transcatheter aortic valve implantation are usually older adults with multiple comorbidities and often frail. Frailty reflects increased vulnerability to adverse outcomes and is an important factor in this population; however, its impact on postoperative complications and healthcare resource utilization remains uncertain. We investigated the association between preoperative frailty and postoperative outcomes using a nationwide electronic medical records database in Japan. We included patients aged 65 years or older who underwent transcatheter aortic valve implantation between April 2013 and December 2021. Frailty was assessed with the Hospital Frailty Risk Score, with a score of 5 or higher indicating frailty. The primary outcome was acute kidney injury within seven days. Secondary outcomes included major adverse kidney events, blood transfusion within 30 days, and hospital length of stay. Among 781 patients, 237 (30.3%) were classified as frail. Acute kidney injury occurred in 8.8% of non-frail and 12.7% of frail patients. After adjustment for age, sex, comorbidities, baseline estimated glomerular filtration rate, surgical approach, anesthesia type, and hospital size, the odds ratio for acute kidney injury in frail patients was 1.42 (95% confidence interval, 0.83–2.45; P = 0.20). Hospital stay was significantly longer in frail patients, with an adjusted mean difference of 3.45 days. Preoperative frailty was not significantly associated with acute kidney injury or other complications but was associated with prolonged hospitalization. Frailty screening before transcatheter aortic valve implantation may help identify patients at risk of extended hospital stay and guide perioperative care.
Yonekura et al. (Fri,) conducted a cohort in Severe aortic stenosis (n=781). Preoperative frailty (Hospital Frailty Risk Score ≥5) vs. Non-frail (Hospital Frailty Risk Score <5) was evaluated on Acute kidney injury (AKI) within 7 days after surgery (OR 1.42, 95% CI 0.83-2.45, p=0.20). Preoperative frailty was not significantly associated with acute kidney injury within 7 days after transcatheter aortic valve implantation compared to non-frail patients (12.7% vs 8.8%, OR 1.42).