The Clinical Frailty Scale: Upgrade Your Eyeball Test
With the emergence of transcatheter aortic valve replacement (TAVR) as a therapeutic option to treat high-risk older adults suffering from aortic stenosis, the geriatric concept of frailty has assumed mainstream relevance for cardiovascular practitioners. We have eagerly adopted tools to objectify the definition of frailty and accordingly discern good and bad candidates among a pool of complex octogenarians with multiple chronic conditions - a daunting yet mission-critical task. Initial studies published during the first half of this decade revealed that frailty status was one of the top predictors of mid-term mortality and incident disability after TAVR1, leading to its integration in clinical care pathways and predictive risk models. The encouraging findings from small single-center studies are now being validated in larger multi-center registries and trials, affirming the strengths and uncovering the limitations of various frailty assessment tools.
- Received December 1, 2016.
- Accepted December 14, 2016.