{"doi":"10.1016/j.xjon.2024.05.006","title":"Impact of frailty on outcomes and readmissions after transcatheter and surgical aortic valve replacement in a national cohort","abstract":"Objective We examined the effect of frailty on in-hospital mortality, readmission rates, and hospitalization costs after transcatheter and surgical aortic valve replacement in a population-level cohort. Methods The Nationwide Readmissions Database was queried for patients who underwent transcatheter or surgical aortic valve replacement during 2016-2018. Multivariate logistic regression was used to discern independent effects of frailty on outcomes. Kaplan–Meier time-to-event analysis was used to evaluate the effect of frailty on freedom from readmission. Results A total of 243,619 patients underwent aortic valve replacement: 142,786 (58.6%) transcatheter aortic valve replacements and 100,833 (41.4%) surgical aortic valve replacements. Frail patients constituted 16,388 (11.5%) and 7251 (7.2%) in the transcatheter aortic valve replacement and surgical aortic valve replacement cohorts, respectively. Compared with nonfrail patients, frail patients had greater in-hospital mortality (transcatheter aortic valve replacement: 3.2% vs 1.1%; surgical aortic valve replacement: 6.1% vs 2.0%; both P < . 001), longer length of stay (transcatheter aortic valve replacement: 4 vs 2 days; surgical aortic valve replacement: 13 vs 6 days; P < . 001), and greater cost (transcatheter aortic valve replacement: $51,654 vs $44,401; surgical aortic valve replacement: $60,782 vs $40,544; P < . 001). Time-to-event analysis showed that frail patients had higher rates of readmission over the calendar year in both transcatheter aortic valve replacement ( P < . 001) and surgical aortic valve replacement ( P < . 001) cohorts. This association persisted on adjusted multivariate regression for mortality (transcatheter aortic valve replacement odds ratio [95% CI] 1.98 [1.65-2.37], surgical aortic valve replacement 1.96 [1.60-2.41]), 30-day readmission (transcatheter aortic valve replacement 1.38 [1.27-1.49], surgical aortic valve replacement 1.47 [1.30-1.65]), and 90-day readmission (transcatheter aortic valve replacement 1.41 [1.31-1.52], surgical aortic valve replacement 1.60 [1.43-1.79]) ( P < . 001 for all). Conclusions For patients undergoing transcatheter or surgical aortic valve replacement, frailty is associated with in-hospital mortality, readmission, and higher costs. Further efforts to optimize outcomes for frail patients are warranted.","journal":"JTCVS Open","year":2024,"id":451480,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":3,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9238,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":584601,"name":"Christopher T. Ryan","orcid":"0000-0003-2831-4397","position":1,"is_corresponding":false},{"id":258169,"name":"Katie Hogan","orcid":"0000-0003-1244-4541","position":2,"is_corresponding":false},{"id":1272918,"name":"Bhavesh S. Sayal","orcid":"0000-0002-1205-8440","position":3,"is_corresponding":false},{"id":527313,"name":"Christopher B. Sylvester","orcid":"0000-0001-7576-7546","position":4,"is_corresponding":false},{"id":279687,"name":"Todd K. Rosengart","orcid":null,"position":5,"is_corresponding":false},{"id":232108,"name":"Joseph S. Coselli","orcid":"0000-0003-2176-5988","position":6,"is_corresponding":false},{"id":278781,"name":"Marc R. Moon","orcid":"0000-0002-4473-6867","position":7,"is_corresponding":false},{"id":703099,"name":"Ravi K. Ghanta","orcid":"0000-0003-3299-2668","position":8,"is_corresponding":false},{"id":310987,"name":"Subhasis Chatterjee","orcid":"0000-0002-0803-8826","position":9,"is_corresponding":false},{"id":1221552,"name":"Travis J Miles","orcid":"0009-0008-2687-2380","position":0,"is_corresponding":true}],"reference_count":32,"raw_metadata":null,"created_at":"2026-07-19T02:02:45.951080Z","pmid":"39296446","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}