What is the clinical evidence from this study?

Study design: Cohort. Population: Aortic Stenosis (n=123). Intervention: Preoperative handgrip strength vs. Lower handgrip strength. Primary outcome: One-year composite outcome of all-cause death or rehospitalization (HR 0.93, 95% CI 0.88-0.98, p=0.006).

What question did this study set out to answer?

The study aims to identify preoperative frailty components associated with one-year outcomes following transcatheter aortic valve implantation.

June 20, 2026Open Access

Association of Frailty Factors, Especially Handgrip Strength, With One-Year Clinical Prognosis Following Transcatheter Aortic Valve Implantation: A Retrospective Cohort Analysis

KTKenji Tsujimoto SWShinichi Watanabe

Key Result

Higher preoperative handgrip strength was an independent predictor of a lower risk of one-year all-cause death or rehospitalization following transcatheter aortic valve implantation (HR 0.93).

Key Points

The study aims to identify preoperative frailty components associated with one-year outcomes following transcatheter aortic valve implantation.
Retrospective cohort study of 123 patients undergoing TAVI.
Assessment of preoperative frailty using the Clinical Frailty Scale and physical/nutritional components.
Performed univariate and multivariate Cox proportional hazards analyses adjusted for age and sex.
In univariate analysis, higher CFS score (≥ 5) indicated worse outcomes (HR: 2.11, p=0.032).
Handgrip strength was significantly associated with outcomes (HR: 0.95, p=0.034) and remained an independent predictor in multivariate analysis (HR: 0.93, 95% CI: 0.88-0.98, p=0.006).
Kaplan-Meier analysis showed significantly lower event-free survival in patients with low handgrip strength.

Study Design

Type

Cohort (n=123)

Multicenter

Structured PICO

Does preoperative handgrip strength predict one-year composite outcomes of all-cause death or rehospitalization in older patients undergoing TAVI?

Population

123 older adults who underwent transcatheter aortic valve implantation and completed preoperative frailty assessments, followed for one year.

Exposure

Preoperative frailty assessment including handgrip strength, short physical performance battery (SPPB), serum albumin, and Clinical Frailty Scale (CFS)

Outcome

Composite of all-cause death or rehospitalization at one yearcomposite

Preoperative handgrip strength is an independent predictor of one-year all-cause death or rehospitalization following TAVI, suggesting its utility for risk stratification.

Main Result

Hazard Ratio: 0.93 (95% CI 0.88–0.98)

p-value: p=0.006

Limitations

Single-center retrospective study design, which cannot exclude selection bias.
Relatively small number of clinical events.
Detailed aspects of rehabilitation content, such as intensity and exercise modality, were not fully assessed.
Frailty assessment may have been biased toward physical domains, lacking comprehensive cognitive and psychosocial evaluation.
External validity may be limited as the study was conducted in a single-center setting involving an older Japanese population.
Missing data due to the retrospective nature of data collection in routine clinical practice.

Abstract

Introduction: Frailty is an important determinant of prognosis in older patients undergoing transcatheter aortic valve implantation (TAVI). However, because frailty is a multidimensional construct, the specific components that most strongly influence long-term outcomes remain unclear. This study aimed to identify the preoperative frailty components associated with one-year composite outcomes after TAVI. Methods and results: This retrospective cohort study included 123 patients who underwent TAVI. Preoperative frailty was assessed using the Clinical Frailty Scale (CFS), and its components were evaluated across physical (handgrip strength and short physical performance battery (SPPB)) and nutritional (serum albumin) domains. Univariate and multivariate Cox proportional hazards analyses were performed using multivariate models adjusted for age and sex. During the one-year follow-up period, 32 events (all-cause death or rehospitalization) occurred. In the univariate analysis, preoperative frailty, defined as a Clinical Frailty Scale (CFS) score ≥ 5 (hazard ratio (HR): 2.11, p=0.032), and handgrip strength (HR: 0.95, p=0.034) were significantly associated with the outcomes. In the multivariate analysis, only handgrip strength remained an independent predictor (HR: 0.93, 95% confidence interval (CI): 0.88-0.98, p=0.006). Receiver operating characteristic (ROC) analysis identified an exploratory cutoff value of 13.3 kg (area under the curve=0.622), and Kaplan-Meier analysis showed significantly lower event-free survival in patients with low handgrip strength. Conclusion: Preoperative handgrip strength was an independent predictor of the one-year post-TAVI outcomes. It may serve as a practical tool for risk stratification and individualized rehabilitation planning.

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Cite This Study

Tsujimoto et al. (Fri,) conducted a cohort in Aortic Stenosis (n=123). Preoperative handgrip strength vs. Lower handgrip strength was evaluated on One-year composite outcome of all-cause death or rehospitalization (HR 0.93, 95% CI 0.88-0.98, p=0.006). Higher preoperative handgrip strength was an independent predictor of a lower risk of one-year all-cause death or rehospitalization following transcatheter aortic valve implantation (HR 0.93).

synapsesocial.com/papers/6a3721e201fe431c25188950 https://doi.org/https://doi.org/10.7759/cureus.111171

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