Impact of frailty on clinical outcomes in elderly patients after transcatheter aortic valve replacement

Objective: Frailty is increasingly recognized as a key determinant of outcomes in elderly patients undergoing transcatheter aortic valve replacement (TAVR).However, the optimal approach for frailty assessment in routine practice remains uncertain.Methods: We performed a retrospective single-center study including elderly patients (≥60 years, consistent with WHO definitions for developing countries) with symptomatic severe aortic stenosis undergoing TAVR.Frailty status was assessed using three routinely available clinical indicators: hypoalbuminemia, anemia, and dependence in activities of daily living (ADL).Frailty severity was defined by the number of abnormal indicators (0-3).The primary endpoint was a composite of procedural failure, major complications, and all-cause mortality at 1, 6, and 12 months.Results: Seventy-three patients were included.Composite adverse outcomes occurred in 34.3%, 37.0%, and 38.4% at 1, 6, and 12 months.Severe frailty (three indicators) was associated with significantly higher event rates.Severe frailty remained an independent predictor of 12-month composite outcomes (OR 5.44; 95% CI 1.68-7.52).Conclusion: A simple three-component frailty score based on albumin, hemoglobin, and ADL dependence effectively identifies high-risk elderly TAVR candidates.Incorporating this frailty assessment into preprocedural evaluation may support better risk stratification and clinical decision-making.