Osteosarcopenia in older adults undergoing transcatheter aortic valve replacement: A narrative review of mortality and frailty implications

Table 2 Evolution of osteosarcopenia/frailty assessment in aortic valve replacement of FRAILTY-AVR studies (2017 and 2024)

Characteristic	2017 study (Afilalo et al[4])	2024 study (Solla-Suarez et al[7])
Study population	1020 patients, median age 82 years (interquartile range: 77–86 years), undergoing TAVR (n = 646) or surgical aortic valve replacement (n = 374)	605 patients, aged 70 years or older (mean age 826 years ± 6.2 years), undergoing TAVR
Grouping method	Comparison of seven frailty scales: Fried, Fried+, Rockwood, Short Physical Performance Battery, Bern, Columbia, EFT	Assessment of osteosarcopenia using computed tomography scans to measure psoas muscle area and vertebral bone density
Follow-up period	One year for primary outcome; 30 days for secondary outcomes	One year for primary outcome; 30 days for secondary outcomes
Primary outcome	One-year all-cause mortality; 145 deaths (14%), EFT was the strongest predictor (aOR = 3.72; 95%CI: 2.54–5.45)	One-year all-cause mortality; 84 deaths (13.9%), osteosarcopenia associated with a 318-fold increase (aOR = 3.18; 95%CI: 1.54–6.57)
Secondary outcomes	30-day mortality: 4.2% (43 deaths), EFT aOR = 3.29 (95%CI: 1.73–6.26). Composite of death or worsening disability at one year: 35% incidence (357/1,020), EFT aOR = 2.13 (95%CI: 1.57–2.87)	30-day mortality: 3.6% (21 deaths), hospital length of stay: Mean 6.5 days ± 8.0 days, discharge not to home: 20.5% (120/585), worsening disability at one year: 40.6% (215/529), osteosarcopenia OR = 2.11 (95%CI: 1.19–3.74)

AOR: Adjusted odds ratio; EFT: Essential Frailty Toolset; TAVR: Transcatheter aortic valve replacement.