{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T12:23:10Z","timestamp":1781007790076,"version":"3.54.1"},"reference-count":36,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"19","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2021,10,5]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">In aortic valve disease, the relationship between claims\u2010based frailty indices (CFIs) and validated measures of frailty constructed from in\u2010person assessments is unclear but may be relevant for retrospective ascertainment of frailty status when otherwise unmeasured.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              We linked adults aged \u226565\u00a0years in the US CoreValve Studies (linkage rate, 67%; mean age, 82.7\u00b16.2\u00a0years, 43.1% women), to Medicare inpatient claims, 2011 to 2015. The Johns Hopkins CFI, validated on the basis of the Fried index, was generated for each study participant, and the association between CFI tertile and trial outcomes was evaluated as part of the EXTEND\u2010FRAILTY substudy. Among 2357 participants (64.9% frail), higher CFI tertile was associated with greater impairments in nutrition, disability, cognition, and self\u2010rated health. The primary outcome of all\u2010cause mortality at 1 year occurred in 19.3%, 23.1%, and 31.3% of those in tertiles 1 to 3, respectively (tertile 2 versus 1: hazard ratio, 1.22; 95% CI, 0.98\u20131.51;\n              <jats:italic>P<\/jats:italic>\n              =0.07; tertile 3 versus 1: hazard ratio, 1.73; 95% CI, 1.41\u20132.12;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001). Secondary outcomes (bleeding, major adverse cardiovascular and cerebrovascular events, and hospitalization) were more frequent with increasing CFI tertile and persisted despite adjustment for age, sex, New York Heart Association class, and Society of Thoracic Surgeons risk score.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">In linked Medicare and CoreValve study data, a CFI based on the Fried index consistently identified individuals with worse impairments in frailty, disability, cognitive dysfunction, and nutrition and a higher risk of death, hospitalization, bleeding, and major adverse cardiovascular and cerebrovascular events, independent of age and risk category. While not a surrogate for validated metrics of frailty using in\u2010person assessments, use of this CFI to ascertain frailty status among patients with aortic valve disease may be valid and prognostically relevant information when otherwise not measured.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.121.022150","type":"journal-article","created":{"date-parts":[[2021,9,29]],"date-time":"2021-09-29T09:32:26Z","timestamp":1632907946000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":13,"title":["Identification of Frailty Using a Claims\u2010Based Frailty Index in the CoreValve Studies: Findings from the EXTEND\u2010FRAILTY Study"],"prefix":"10.1161","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6592-6141","authenticated-orcid":false,"given":"Jordan B.","family":"Strom","sequence":"first","affiliation":[{"name":"Department of Medicine Cardiovascular Division Beth Israel Deaconess Medical Center Boston MA"},{"name":"Richard A. and Susan F. Smith Center for Outcomes Research in Cardiology Beth Israel Deaconess Medical Center Boston MA"},{"name":"Harvard Medical School Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiaman","family":"Xu","sequence":"additional","affiliation":[{"name":"Richard A. and Susan F. Smith Center for Outcomes Research in Cardiology Beth Israel Deaconess Medical Center Boston MA"},{"name":"Harvard Medical School Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ariela R.","family":"Orkaby","sequence":"additional","affiliation":[{"name":"Harvard Medical School Boston MA"},{"name":"Department of Medicine Veterans Affairs Healthcare System Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Changyu","family":"Shen","sequence":"additional","affiliation":[{"name":"Richard A. and Susan F. Smith Center for Outcomes Research in Cardiology Beth Israel Deaconess Medical Center Boston MA"},{"name":"Harvard Medical School Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian R.","family":"Charest","sequence":"additional","affiliation":[{"name":"Harvard Medical School Boston MA"},{"name":"Department of Medicine Veterans Affairs Healthcare System Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dae H.","family":"Kim","sequence":"additional","affiliation":[{"name":"Harvard Medical School Boston MA"},{"name":"Division of Gerontology Beth Israel Deaconess Medical Center Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9163-724X","authenticated-orcid":false,"given":"David J.","family":"Cohen","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Foundation New York NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4241-3586","authenticated-orcid":false,"given":"Daniel B.","family":"Kramer","sequence":"additional","affiliation":[{"name":"Department of Medicine Cardiovascular Division Beth Israel Deaconess Medical Center Boston MA"},{"name":"Richard A. and Susan F. Smith Center for Outcomes Research in Cardiology Beth Israel Deaconess Medical Center Boston MA"},{"name":"Harvard Medical School Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2839-2611","authenticated-orcid":false,"given":"John A.","family":"Spertus","sequence":"additional","affiliation":[{"name":"Section of Cardiovascular Disease University of Missouri\u2010Kansas City School of Medicine Kansas City MO"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6767-7687","authenticated-orcid":false,"given":"Robert E.","family":"Gerszten","sequence":"additional","affiliation":[{"name":"Department of Medicine Cardiovascular Division Beth Israel Deaconess Medical Center Boston MA"},{"name":"Harvard Medical School Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0564-4468","authenticated-orcid":false,"given":"Robert W.","family":"Yeh","sequence":"additional","affiliation":[{"name":"Department of Medicine Cardiovascular Division Beth Israel Deaconess Medical Center Boston MA"},{"name":"Richard A. and Susan F. 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