Summary
This multinational prospective cohort study of 759 older adults (340 women, 419 men) undergoing transcatheter aortic valve replacement examined sex-specific determinants of outcomes and the role of frailty. Women were older with higher predicted mortality risk and greater prevalence of physical frailty traits, yet 12-month mortality was not significantly higher in women overall, with the exception of those with pulmonary hypertension. The findings suggest that whilst women required more post-discharge rehabilitation support, particularly those with physical frailty, frailty indices themselves were similarly prognostic across sexes.
UK applicability
The findings from this North American and European cohort may inform United Kingdom practice regarding sex-specific risk stratification and frailty assessment in transcatheter aortic valve replacement programmes. UK centres may consider the study's evidence on discharge planning for women with physical frailty traits when implementing local protocols.
Key measures
12-month mortality; 1-month mortality or major morbidity composite; physical, cognitive, and psychosocial frailty traits; discharge disposition; functional status at 12 months
Outcomes reported
The study measured 12-month mortality (primary outcome) and 1-month composite mortality or major morbidity (secondary outcome) in older women and men undergoing transcatheter aortic valve replacement, with stratification by sex and assessment of frailty phenotypes.
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