Impact of preprocedural frailty on long-term mortality after transcatheter aortic valve replacement: a systematic review and meta-analysis
- 1Department of Nursing, The Second Affiliated Hospital of Zhejiang, University School of Medicine, Hangzhou, 310009 China
Abstract
Background: This study aimed to investigate the association between preprocedural frailty and long-term all-cause mortality in patients undergoing transcatheter aortic valve replacement (TAVR).
Methods: A systematic search of PubMed, Web of Science, Embase, CINAHL, Scopus, and the Cochrane Library was conducted from database inception to 15 February 2026. The methodological quality of the included studies was assessed using the Newcastle–Ottawa Scale (NOS). A random-effects meta-analysis was performed to pool adjusted hazard ratios (HRs) with their corresponding 95% confidence intervals (CIs).
Results: Thirteen cohort studies involving 429,827 patients were included in the systematic review. Of these, 8 studies (4,726 patients) reporting comparable adjusted effect estimates were included in the quantitative meta-analysis. Preprocedural frailty was associated with a higher risk of long-term all-cause mortality after TAVR (HR = 1.85, 95% CI 1.51–2.25; I² = 39.4%). The association was generally consistent across subgroup analyses stratified by follow-up duration and frailty assessment methodology. Five studies that were not amenable to quantitative pooling because of non-comparable effect formats or data structures showed a concordant direction of effect, with some studies demonstrating a graded relationship between increasing frailty burden and mortality risk.
Conclusions: Preprocedural frailty is significantly associated with increased long-term all-cause mortality in older adults undergoing TAVR. These findings support the incorporation of frailty assessment into routine preprocedural geriatric risk stratification and multidisciplinary decision-making.
Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12872-026-06436-x.
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BibTeX
@article{zhan2026impact,
title = {{Impact of preprocedural frailty on long-term mortality after transcatheter aortic valve replacement: a systematic review and meta-analysis}},
author = {Yang Zhan and Yue Mao and Xiaolan Tang and Rong Li and Mei Li and Daoxin Hua},
journal = {BMC Cardiovascular Disorders},
year = {2026},
month = aug,
doi = {10.1186/s12872-026-06436-x},
url = {https://doi.org/10.1186/s12872-026-06436-x},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Impact of preprocedural frailty on long-term mortality after transcatheter aortic valve replacement: a systematic review and meta-analysis
AU - Yang Zhan
AU - Yue Mao
AU - Xiaolan Tang
AU - Rong Li
AU - Mei Li
AU - Daoxin Hua
PY - 2026
DA - 2026/08/07
JO - BMC Cardiovascular Disorders
DO - 10.1186/s12872-026-06436-x
UR - https://doi.org/10.1186/s12872-026-06436-x
AB - Background: This study aimed to investigate the association between preprocedural frailty and long-term all-cause mortality in patients undergoing transcatheter aortic valve replacement (TAVR). Methods: A systematic search of PubMed, Web of Science, Embase, CINAHL, Scopus, and the Cochrane Library was conducted from database inception to 15 February 2026. The methodological quality of the included studies was assessed using the Newcastle–Ottawa Scale (NOS). A random-effects meta-analysis was performed to pool adjusted hazard ratios (HRs) with their corresponding 95% confidence intervals (CIs). Results: Thirteen cohort studies involving 429,827 patients were included in the systematic review. Of these, 8 studies (4,726 patients) reporting comparable adjusted effect estimates were included in the quantitative meta-analysis. Preprocedural frailty was associated with a higher risk of long-term all-cause mortality after TAVR (HR = 1.85, 95% CI 1.51–2.25; I² = 39.4%). The association was generally consistent across subgroup analyses stratified by follow-up duration and frailty assessment methodology. Five studies that were not amenable to quantitative pooling because of non-comparable effect formats or data structures showed a concordant direction of effect, with some studies demonstrating a graded relationship between increasing frailty burden and mortality risk. Conclusions: Preprocedural frailty is significantly associated with increased long-term all-cause mortality in older adults undergoing TAVR. These findings support the incorporation of frailty assessment into routine preprocedural geriatric risk stratification and multidisciplinary decision-making. Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12872-026-06436-x.
SN - 1471-2261
ER -