Objectives 

Frailty is common amongst patients undergoing transcatheter aortic valve implantation (TAVI). The aim of this study was to determine the prognostic relevance of newer objective and traditional measures of frailty after TAVI.

Methods 

Consecutive patients were identified from the Leeds Teaching Hospitals Trust TAVI database. Frailty was quantified objectively by measuring the total psoas muscle area (TPMA) on routine computer tomography scans and compared against Canadian Study of Health and Aging Clinical Frailty Score, Katz Index of independence in activities of daily living and Clinician Estimated Poor Mobility. Postintervention morbidity and mortality were examined between these scoring systems.

Results 

The current study included 420 patients who had undergone TAVI between January 2013 and December 2015. Median clinical follow-up was 4.0 years (interquartile range 2.9–5.0). Standardized measurements of the TPMA were not associated with either postintervention morbidity or mortality. Only the Canadian Study of Health and Aging Clinical Frailty Score was associated with hospital stay (adjusted regression coefficient 0.70, 95% confidence interval 0.04–1.36, P = 0.038) and overall all-cause mortality (adjusted regression coefficient 1.26, 95% confidence interval 1.05–1.50, P = 0.013). There were no significant correlations between TPMA and any of the traditional frailty tools.

Conclusion 

We demonstrate TPMA to be a poor measure of patient frailty when compared with traditional methods of assessment which failed to predict postintervention outcomes. Furthermore, morphometric sarcopaenia correlated poorly with established measures of frailty.

中文翻译：

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经导管主动脉瓣植入的形态和传统脆弱评估。

目标 

在经导管主动脉瓣植入术（TAVI）的患者中，虚弱是常见的。这项研究的目的是确定TAVI后新的客观和传统的身体虚弱措施的预后相关性。

方法 

从利兹教学医院信托TAVI数据库中识别出连续患者。通过在常规计算机断层扫描中测量总腰大肌面积（TPMA）来客观地定量虚弱，并将其与加拿大健康与衰老研究，临床虚弱评分，日常活动的独立性Katz指数以及临床医生估计的行动不便进行比较。在这些评分系统之间检查了干预后的发病率和死亡率。

结果 

当前的研究包括420例在2013年1月至2015年12月期间接受过TAVI的患者。中位临床随访时间为4.0年（四分位间距2.9-5.0）。TPMA的标准化测量与干预后发病率或死亡率均无关。仅加拿大健康与衰老临床脆弱性研究报告与住院时间（校正回归系数0.70，95％置信区间0.04–1.36，P = 0.038）和整体全因死亡率（校正回归系数1.26，95 ％置信区间）相关1.05-1.50，P = 0.013）。TPMA与任何传统的脆弱工具之间没有显着相关性。

结论 

与传统的评估方法无法预测干预后的结果相比，我们证明TPMA不能很好地衡量患者的虚弱程度。此外，形态学上的斜纹肌与已确立的体弱测量值之间的相关性很差。