{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T18:46:31Z","timestamp":1782413191004,"version":"3.54.5"},"reference-count":25,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2019,6,18]],"date-time":"2019-06-18T00:00:00Z","timestamp":1560816000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100007299","name":"Harvard Catalyst","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007299","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["KL2 TR001100\u201001"],"award-info":[{"award-number":["KL2 TR001100\u201001"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["UL1 TR001102"],"award-info":[{"award-number":["UL1 TR001102"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000097","name":"National Center for Research Resources","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000097","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["2T35AG038027\u201006"],"award-info":[{"award-number":["2T35AG038027\u201006"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["K08AG051187"],"award-info":[{"award-number":["K08AG051187"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["P30AG031679"],"award-info":[{"award-number":["P30AG031679"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["P30AG048785"],"award-info":[{"award-number":["P30AG048785"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["agsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J American Geriatrics Society"],"published-print":{"date-parts":[[2019,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Despite evidence, frailty is not routinely assessed before cardiac surgery. We compared five brief frailty tests for predicting poor outcomes after aortic valve replacement and evaluated a strategy of performing comprehensive geriatric assessment (CGA) in screen\u2010positive patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Prospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>A single academic center.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Patients undergoing surgical aortic valve replacement (SAVR) (n = 91; mean age = 77.8 y) or transcatheter aortic valve replacement (TAVR) (n = 137; mean age = 84.5 y) from February 2014 to June 2017.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements<\/jats:title>\n                    <jats:p>Brief frailty tests (Fatigue, Resistance, Ambulation, Illness, and Loss of weight [FRAIL] scale; Clinical Frailty Scale; grip strength; gait speed; and chair rise) and a deficit\u2010accumulation frailty index based on CGA (CGA\u2010FI) were measured at baseline. A composite of death or functional decline and severe symptoms at 6 months was assessed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The outcome occurred in 8.8% (n = 8) after SAVR and 24.8% (n = 34) after TAVR. The chair rise test showed the highest discrimination in the SAVR (C statistic = .76) and TAVR cohorts (C statistic = .63). When the chair rise test was chosen as a screening test (\u226517\u2009s for SAVR and\u2009\u226523\u2009s for TAVR), the incidence of outcome for screen\u2010negative patients, screen\u2010positive patients with CGA\u2010FI of .34 or lower, and screen\u2010positive patients with CGA\u2010FI higher than .34 were 1.9% (n = 1\/54), 5.3% (n = 1\/19), and 33.3% (n = 6\/18) after SAVR, respectively, and 15.0% (n = 9\/60), 14.3% (n = 3\/21), and 38.3% (n = 22\/56) after TAVR, respectively. Compared with routinely performing CGA, targeting CGA to screen\u2010positive patients would result in 54 fewer CGAs, without compromising sensitivity (routine vs targeted: .75 vs .75;\n                      <jats:italic>P<\/jats:italic>\n                      = 1.00) and specificity (.84 vs .86;\n                      <jats:italic>P<\/jats:italic>\n                      = 1.00) in the SAVR cohort; and 60 fewer CGAs with lower sensitivity (.82 vs.65;\n                      <jats:italic>P<\/jats:italic>\n                      = .03) and higher specificity (.50 vs .67;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.01) in the TAVR cohort.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      The chair rise test with targeted CGA may be a practical strategy to identify older patients at high risk for mortality and poor recovery after SAVR and TAVR in whom individualized care management should be considered.\n                      <jats:bold>J Am Geriatr Soc 67:2031\u20132037, 2019<\/jats:bold>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgs.16036","type":"journal-article","created":{"date-parts":[[2019,6,18]],"date-time":"2019-06-18T11:45:07Z","timestamp":1560858307000},"page":"2031-2037","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":30,"title":["A Practical Two\u2010Stage Frailty Assessment for Older Adults Undergoing Aortic Valve Replacement"],"prefix":"10.1111","volume":"67","author":[{"given":"Quinn P.","family":"Hosler","sequence":"first","affiliation":[{"name":"University of Cincinnati College of Medicine Cincinnati Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony J.","family":"Maltagliati","sequence":"additional","affiliation":[{"name":"University of Arizona College of Medicine Tucson Arizona"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6801-5602","authenticated-orcid":false,"given":"Sandra M.","family":"Shi","sequence":"additional","affiliation":[{"name":"Division of Gerontology Beth Israel Deaconess Medical Center Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Afilalo","sequence":"additional","affiliation":[{"name":"Division of Cardiology and Centre for Clinical Epidemiology Jewish General Hospital, McGill University Montreal Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey J.","family":"Popma","sequence":"additional","affiliation":[{"name":"Division of Cardiology Beth Israel Deaconess Medical Center Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kamal R.","family":"Khabbaz","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery, Department of Surgery Beth Israel Deaconess Medical Center Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roger J.","family":"Laham","sequence":"additional","affiliation":[{"name":"Division of Cardiology Beth Israel Deaconess Medical Center Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimberly","family":"Guibone","sequence":"additional","affiliation":[{"name":"Division of Cardiology Beth Israel Deaconess Medical Center Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7290-6838","authenticated-orcid":false,"given":"Dae Hyun","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Gerontology Beth Israel Deaconess Medical Center Boston Massachusetts"},{"name":"Marcus Institute for Aging Research, Hebrew SeniorLife Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,6,18]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.7326\/M16-0652"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2017.06.024"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.4244\/EIJV11I10A253"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2012.07.002"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afu157"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/anae.12494"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(08)60342-6"},{"key":"e_1_2_6_9_1","first-page":"CD006211","article-title":"Comprehensive geriatric assessment for older adults admitted to hospital","volume":"9","author":"Ellis G","year":"2017","journal-title":"Cochrane Database Syst 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For providers: online tool to calculate frailty index (FI).https:\/\/www.bidmc.org\/research\/research\u2010by\u2010department\/medicine\/gerontology\/calculator. Accessed December 23 2018."},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afw039"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/gly197"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/gly232"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.18637\/jss.v045.i04"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/0021-9681(87)90171-8"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2017.1630"},{"key":"e_1_2_6_25_1","unstructured":"Centers for Medicare & Medicaid Services.Decision memo for transcatheter aortic valve replacement (TAVR) (CAG\u201000430N).https:\/\/www.cms.gov\/medicare\u2010coverage\u2010database\/details\/nca\u2010decision\u2010memo.aspx?NCAId=257. 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