Key result
Frailty is linked to a ~109% increase in major adverse events after T-TEER.
Why the study?
Frailty commonly coexists with severe tricuspid regurgitation, but its impact on outcomes following T-TEER remains unclear.
Does frailty worsen in-hospital outcomes and 90-day readmissions in adults undergoing tricuspid transcatheter edge-to-edge repair?
Cohort (n=3,046)
Yes
Does frailty worsen in-hospital outcomes and 90-day readmissions in adults undergoing tricuspid transcatheter edge-to-edge repair?
Odds Ratio: 2.09 (95% CI 1.03–4.26)
Absolute Event Rate: 29.8% vs 16.9%
p-value: p=0.04
Frailty is associated with a twofold higher risk of in-hospital major adverse events and increased resource utilization after tricuspid TEER, highlighting the need for frailty assessment in patient selection.
Frailty was associated with higher MAEs after tricuspid TEER; hypothesis-generating for frailty assessment pending prospective validation.
Background Frailty commonly coexists with severe tricuspid regurgitation, but its impact on outcomes following tricuspid transcatheter edge-to-edge repair (T-TEER) remains unclear. Aims To assess the prevalence of frailty among patients undergoing T-TEER and its association with in-hospital outcomes and short-term readmissions in the United States. Methods A retrospective cohort study was conducted using the Nationwide Readmissions Database (2016–2022) to identify hospitalizations for T-TEER among adults. Frailty was defined using ≥1 Johns Hopkins Adjusted Clinical Groups diagnostic cluster. The primary outcome was major adverse events (MAEs), a composite of in-hospital mortality, major bleeding, vascular complications, pericardial effusion requiring intervention, or conversion to surgery. Secondary outcomes included individual components of the primary outcome, length of stay (LOS), costs, discharge disposition, and 90-day readmissions. Propensity score matching (PSM) was performed to adjust for potential confounders. Results Among 3,046 weighted T-TEER hospitalizations, 171 (5.6%) were classified as frail. After PSM, frailty was associated with higher rates of MAE (29.8% vs 16.9%; odds ratio 2.09, 95% CI 1.03–4.26; p=0.04), major bleeding, and acute kidney injury, longer LOS (12 vs 6 days; p<0.001), higher costs ($86,308 vs $68,690; p<0.001), and numerically higher nonhome discharges (21.1% vs 11.3%; p=0.10). Other in-hospital complications and 90-day all-cause readmissions (hazard ratio 1.24; 95% CI 0.63–2.47; p=0.53) were not significantly different between frail and non-frail groups. Conclusions Frailty is associated with worse in-hospital outcomes after T-TEER but no statistically significant difference in 90-day readmissions was detected. Incorporating frailty assessment may aid prognostication and risk stratification to optimize patient selection for T-TEER.
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Ismayl et al. (2026) conducted a cohort in Severe tricuspid regurgitation undergoing T-TEER (n=3,046). Frailty vs. Non-frail was evaluated on Major adverse events (MAEs), a composite of in-hospital mortality, major bleeding, vascular complications, pericardial effusion requiring intervention, or conversion to surgery (OR 2.09, 95% CI 1.03-4.26, p=0.04). Frailty was associated with a higher rate of major adverse events after tricuspid transcatheter edge-to-edge repair compared to non-frail patients (29.8% vs 16.9%; OR 2.09; 95% CI 1.03-4.26; P=0.04).
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