The following is a summary of “Frailty, periinterventional complications and outcome in patients undergoing percutaneous mitral and tricuspid valve repair,” published in the February 2024 issue of Cardiology by Schäfer et al.
Researchers conducted a retrospective study to examine how frailty, prevalent in elderly and multimorbid patients, heightens susceptibility to stressors.
They evaluated frailty using the Fried criteria in consecutive patients undergoing transcatheter mitral and tricuspid valve repair at a single center and analyzed records for postprocedural infections, blood transfusions, bleeding events, and renal failure. The median follow-up duration for survival was 560 days (IQR: 363 to 730 days).
The results showed that among 626 patients, 90% underwent mitral valve repair, 5% underwent tricuspid valve repair, and 5% underwent simultaneous mitral and tricuspid valve repair. 47% of patients were classified as frail. Frailty was significantly linked to a higher occurrence of bleeding (16% vs. 10%; P=0.016), blood transfusions (9% vs. 3%; P<0.001), and infections (18% vs. 10%; P=0.006), but not with acute kidney injury (20% vs. 20%; P=1.00). Both bleeding and infections correlated with prolonged hospital stays, with a more pronounced impact observed in frail patients (interaction test P<0.05, resulting in an additional 3.2 and 4.1 days in frail patients). Even after adjusting for the occurrence of complications, the heightened mortality risk associated with frailty persisted (HR 2.24 [95% CI 1.62–3.10]; P<0.001).
Investigators concluded that, while frailty in mitral/tricuspid valve repair patients was linked to higher bleeding, infection, and hospital stay, it independently predicted long-term mortality, suggesting mechanisms beyond complications need further investigation to help this vulnerable population.
Source: link.springer.com/article/10.1007/s00392-024-02397-3