BMC Geriatrics · Oct 30, 2026
Prognostic value of the modified frailty index-5 for early and long-term outcomes in patients undergoing transcatheter aortic valve implantation
By Guvendi Sengor B, Hakgor A, Kultursay B et al.
Frailty is an important determinant of outcomes in patients undergoing transcatheter aortic valve implantation (TAVI) and can be assessed using the 5-item Modified Frailty Index (MFI-5). This study aimed to evaluate the prognostic value of the MFI-5 for early and long-term outcomes after TAVI. In this retrospective, single-center study, 1260 patients who underwent TAVI between January 2018 and March 2025 were included. Frailty was assessed using the MFI-5 and patients were categorized as non-frail, pre-frail, or frail. The primary outcomes were in-hospital mortality and long-term mortality. Secondary outcomes included postprocedural acute kidney injury (AKI), vascular complications, and permanent pacemaker implantation. Multivariate Cox and logistic regression analyses were performed. Frail patients exhibited a higher burden of comorbidities and a more adverse outcome. Frailty was independently associated with increased in-hospital mortality and postprocedural AKI (OR 2.38, 95% CI 1.07–5.13, p = 0.025; OR 3.48, 95% CI 1.26–14.4, p = 0.038; respectively). In contrast, frailty status was not independently associated with long-term mortality after adjustment for confounders. Instead, advanced age, lower LVEF, higher creatinine levels, and lower albumin levels emerged as independent predictors of long-term mortality (HR 1.04, 95% CI 1.02–1.07, p = 0.002; HR 0.97, 95% CI 0.95–0.98, p < 0.001; HR 1.21, 95% CI 1.00-1.45, p = 0.045; HR 0.63, 95% CI 0.49–0.82, p < 0.001; respectively). Frailty was associated with increased in-hospital mortality and postprocedural AKI in patients undergoing TAVI; however, MFI-5 was not independently associated with long-term mortality after adjustment in this cohort. These findings suggest that frailty may reflect early vulnerability to procedural stress, whereas long-term outcomes appear to be more strongly associated with cardiac, renal and nutritional factors. Not applicable.