Aging clinical and experimental research · 2026
Perioperative frailty in nonagenarians undergoing transcatheter aortic valve implantation: a single-center study.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Kobayashi Kiyonori, Tokuda Yoshiyuki, Tanaka Akihito, Ozeki Takahiro, Murohara Toyoaki, Mutsuga Masato
Аннотация
BACKGROUND: Transcatheter aortic valve implantation (TAVI) has become an established treatment for severe aortic stenosis (AS) in older patients, including nonagenarians. This study aimed to examine perioperative changes in frailty among nonagenarian patients undergoing TAVI.
METHODS AND RESULTS: In this single-center observational analysis, 38 consecutive nonagenarian patients (7.3% of 523 TAVI cases) were evaluated. Frailty parameters-including grip strength, cognitive function (MMSE), overall physical performance (SPPB), gait speed, and activities of daily living (Katz index)-were measured before and after the procedure. No significant differences were observed between preoperative and postoperative values for grip strength (17.4 ± 7.1 vs. 16.1 ± 7.4 kgf, p = 0.102), MMSE (24.1 ± 3.9 vs. 24.3 ± 4.6, p = 0.923), or overall SPPB scores (8.7 ± 2.8 vs. 7.5 ± 3.0, p = 0.084). In contrast, gait speed decreased significantly from 0.8 ± 0.3 m/s to 0.7 ± 0.3 m/s (p = 0.001), and the Katz index also showed a small but statistically significant decline (p = 0.042). The proportion of patients with a walking speed below 0.9 m/s did not change significantly (67.6% vs. 83.8%, p = 0.146).
CONCLUSIONS: In a carefully selected nonagenarian cohort, TAVI did not substantially worsen most frailty indices. However, mild in-hospital declines in gait speed and ADL were observed, underscoring the importance of structured early rehabilitation strategies.
METHODS AND RESULTS: In this single-center observational analysis, 38 consecutive nonagenarian patients (7.3% of 523 TAVI cases) were evaluated. Frailty parameters-including grip strength, cognitive function (MMSE), overall physical performance (SPPB), gait speed, and activities of daily living (Katz index)-were measured before and after the procedure. No significant differences were observed between preoperative and postoperative values for grip strength (17.4 ± 7.1 vs. 16.1 ± 7.4 kgf, p = 0.102), MMSE (24.1 ± 3.9 vs. 24.3 ± 4.6, p = 0.923), or overall SPPB scores (8.7 ± 2.8 vs. 7.5 ± 3.0, p = 0.084). In contrast, gait speed decreased significantly from 0.8 ± 0.3 m/s to 0.7 ± 0.3 m/s (p = 0.001), and the Katz index also showed a small but statistically significant decline (p = 0.042). The proportion of patients with a walking speed below 0.9 m/s did not change significantly (67.6% vs. 83.8%, p = 0.146).
CONCLUSIONS: In a carefully selected nonagenarian cohort, TAVI did not substantially worsen most frailty indices. However, mild in-hospital declines in gait speed and ADL were observed, underscoring the importance of structured early rehabilitation strategies.