Kihon checklist is useful for predicting outcomes in patients undergoing transcatheter aortic valve implantation

• Published in: Journal of cardiology 2022-02, Vol.79 (2), p.299-305
• Main Authors: Kure, Yusuke, Okai, Tsukasa, Izumiya, Yasuhiro, Shimizu, Masashi, Yahiro, Ryosuke, Yamaguchi, Tomohiro, Ogawa, Mana, Kishimoto, Noriaki, Shibata, Atsushi, Ito, Asahiro, Takahashi, Yosuke, Ehara, Shoichi, Shibata, Toshihiko, Yoshiyama, Minoru
• Format: Article
• Language: English
• Subjects: Aged, 80 and over; Aortic stenosis; Aortic Valve - surgery; Aortic Valve Stenosis; Checklist; Frail; Frailty - etiology; Humans; Kihon checklist; Male; Risk Factors; Transcatheter aortic valve implantation; Transcatheter Aortic Valve Replacement; Treatment Outcome
• ISSN: 0914-5087; 1876-4738
• DOI: 10.1016/j.jjcc.2021.09.014

•Frailty is a major risk factor for death and disability following transcatheter aortic valve implantation (TAVI).•The Kihon Checklist (KCL) is a screening tool for identifying frailty in the primary care setting.•We investigated the 3-year prognostic impact of frailty by the KCL in patients who underwent TAVI.•Total KCL score was independently associated with 3-year all-cause mortality after TAVI. Frailty is a major risk factor for death and disability following transcatheter aortic valve implantation (TAVI). The Kihon checklist (KCL) is a simple self-reporting yes/no survey consisting of 25 questions and is used as a screening tool to identify frailty in the primary care setting. No clinical studies have focused on frailty calculated by the KCL in the TAVI cohort. We investigated the 3-year prognostic impact of frailty evaluated by the KCL in patients who underwent TAVI. This single-center prospective observational study included 280 consecutive patients with symptomatic severe aortic stenosis who underwent TAVI and evaluated pre-procedural physical performance focused on frailty at our institution. We assessed all patients’ frailty by the KCL before TAVI, as described previously. We set the primary endpoint as the 3-year all-cause mortality after TAVI. The median patient age was 84 years (interquartile range, 81–87 years), and 31.1% were men. In the receiver operating characteristics curve, there were no significant differences between the KCL and Cardiovascular Health Study frailty index [area under the curve (AUC) 0.625 versus 0.628; p=0.93), KCL and Rockwood Clinical Frailty Scale (AUC 0.625 versus 0.542; p=0.15), and KCL and Short Physical Performance Battery (AUC 0.625 versus 0.612; p=0.91). The first and second tertiles of the total KCL score were 8 and 12, respectively. The multivariate Cox regression model indicated that the total KCL score [hazard ratio (HR), 1.104; 95% confidence interval (CI), 1.034–1.179; p=0.003], presence of diabetes mellitus (HR, 1.993; CI, 1.055–3.766; p=0.03), and presence of liver disease (HR, 3.007; CI, 1.067-8.477; p=0.04) were independently associated with 3-year all-cause mortality. The KCL is a simple and useful tool for evaluating frailty status and predicting 3-year all-cause mortality in patients undergoing TAVI. Graphical Abstract [Display omitted]