{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T16:56:56Z","timestamp":1793725016372,"version":"4.6.1"},"reference-count":36,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2023,8,10]],"date-time":"2023-08-10T00:00:00Z","timestamp":1691625600000},"content-version":"unspecified","delay-in-days":9,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Open Heart"],"accepted":{"date-parts":[[2023,7,3]]},"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>Assessment of frailty prior to aortic valve intervention is recommended in European and North American valvular heart disease guidelines. However, there is a lack of consensus on how it is best measured. The Clinical Frailty Scale (CFS) is a well-validated measure of frailty that is relatively quick to calculate. This meta-analysis sought to examine whether the CFS predicts mortality and morbidity following either transcatheter aortic valve implantation (TAVI) or surgical aortic valve replacement (SAVR).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Nine electronic databases were searched systematically for data on clinical outcomes post-TAVI\/SAVR, where patients had undergone preoperative frailty assessment using the CFS. The primary endpoint was 12-month mortality. TAVI and SAVR data were assessed and reported separately. For each individual study, the incidence of adverse outcomes was extracted according to a CFS score of 5\u20139 (ie, frail) versus 1\u20134 (ie, non-frail), with meta-analysis performed using a random effects model.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of 2612 records screened, nine were included in the review (five TAVI, three SAVR and one which included both interventions). Among 4923 TAVI patients, meta-analysis showed 12-month mortality rates of 19.1% for the frail cohort versus 9.8% for the non-frail cohort (RR 2.53 (1.63 to 3.95), p&lt;0.001, I<jats:sup>2<\/jats:sup>=83%). For the smaller cohort of SAVR patients (n=454), mortality rates were 20.3% versus 3.9% for the frail and non-frail cohorts, respectively (RR 5.08 (2.31 to 11.15), p&lt;0.001, I<jats:sup>2<\/jats:sup>=5%).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Frailty, as determined by the CFS, was associated with an increased mortality risk in the 12 months following either TAVI or SAVR. These data would support its use in the preoperative assessment of elderly patients undergoing aortic valve interventions.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/openhrt-2023-002354","type":"journal-article","created":{"date-parts":[[2023,8,11]],"date-time":"2023-08-11T00:45:12Z","timestamp":1691714712000},"page":"e002354","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":26,"title":["Clinical Frailty Scale as a predictor of adverse outcomes following aortic valve replacement: a systematic review and meta-analysis"],"prefix":"10.1136","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1036-9859","authenticated-orcid":false,"given":"Tadhg","family":"Prendiville","sequence":"first","affiliation":[{"name":"Department of Cardiology, Cork University Hospital, Cork, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aoife","family":"Leahy","sequence":"additional","affiliation":[{"name":"Department of Ageing and Therapeutics, University Hospital Limerick, Limerick, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed","family":"Gabr","sequence":"additional","affiliation":[{"name":"Department of Ageing and Therapeutics, University Hospital Limerick, Limerick, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fayeza","family":"Ahmad","sequence":"additional","affiliation":[{"name":"Division of Cardiology and Centre of Clinical Epidemiology, Jewish General Hospital, McGill University, Montreal, Qu\u00e9bec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Afilalo","sequence":"additional","affiliation":[{"name":"Division of Cardiology and Centre of Clinical Epidemiology, Jewish General Hospital, McGill University, Montreal, Qu\u00e9bec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3410-9472","authenticated-orcid":false,"given":"Glen Philip","family":"Martin","sequence":"additional","affiliation":[{"name":"Division of Informatics, Imaging and Data Science, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9241-8890","authenticated-orcid":false,"given":"Mamas","family":"Mamas","sequence":"additional","affiliation":[{"name":"Keele Cardiovascular Research Group, Centre for Prognosis Research, Keele University, Keele, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivan P","family":"Casserly","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Mater Misericordiae University Hospital, Dublin, 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