Perioperative medicine & outcomes
Performance of administrative database frailty instruments in predicting clinical outcomes and cost for patients undergoing transcatheter aortic valve implantation: a historical cohort study
Authors' conclusion
Preoperative frailty assessment may add some predictive value for TAVI outcomes.
Study context
- Population
- Patients aged 66 yr or older undergoing transcatheter aortic valve implantation (TAVI) in Ontario, Canada, 1 April 2012 to 31 March 2018
- Participants
- 3,848 patients
- Exposure
- Johns Hopkins Adjusted Clinical Group (ACG) frailty indicator and Hospital Frailty Risk Score (HFRS) vs reference model
- Outcome
- Performance in predicting in-hospital mortality, one-year mortality, rehospitalization and healthcare costs
Main finding
As reported in the abstract
Prediction of one-year mortality and rehospitalization (NRI) and one-year costs
Each group vs reference modelRelative risk (95% CI)
Johns Hopkins ACG frailty indicatorassociation of frailty with one-year costs
1.13(1.06–1.20)
HFRSassociation of frailty with one-year costs
1.14(1.07–1.21)
- Johns Hopkins ACG frailty indicator · one-year mortality
- Net reclassification index (NRI) 0.160; P < 0.001
- HFRS · one-year mortality
- NRI 0.146; P = 0.001
- Johns Hopkins ACG frailty indicator · rehospitalization
- NRI 0.201; P < 0.001
- HFRS · rehospitalization
- NRI 0.141; P = 0.001
- Johns Hopkins ACG frailty indicator · one-year mortality
- Integrated discrimination improvement (IDI) 0.003; P < 0.001
Observational data: associations, not effects.
Further findings
| Outcome | Johns Hopkins ACG frailty indicator | HFRS |
|---|---|---|
| Frail patients identified | 22.4% | 22.5% |
Agreement between frailty instruments
- Fair agreement between the frailty instruments (Kappa statistic)
- 0.322
- Each instrument classified different subgroups as frail
Original publication
Performance of administrative database frailty instruments in predicting clinical outcomes and cost for patients undergoing transcatheter aortic valve implantation: a historical cohort study. Can J Anaesth. Published 28 December 2022. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →