Work

Associated mortality and time spent in hospital following mitral valve intervention for mitral regurgitation according to frailty status: a nationwide Danish study

Year: 2025

Type: article

Abstract: Aims Little is known about how patient frailty affects mortality and hospitalization following mitral valve intervention for mitral regurgitation (MR). Methods and results Using Danish nationwide registries, we identified patients undergoing first-time mitral valve intervention for MR during the period 1996–2022. Patients were categorized as frail or non-frail based on the Hospital Frailty Risk Score. We assessed 1 year mortality with the reverse Kaplan–Meier estimator, and adjusted comparisons were computed using multivariable-adjusted Cox regression analysis. A composite outcome of death or time in hospital >14 days within 1 year was examined using multivariable-adjusted logistic regression analysis. A total of 7000 patients (90.0%) were considered non-frail (median age 67.0 years, 66.3% male) and 782 (10.0%) were considered frail (median age 71.0 years, 56.3% male). One year mortality was 8.2% among non-frail patients and 13.4% among frail patients (P-value <0.0001), but no statistically significant difference was observed [hazard ratio = 1.16, 95% confidence interval (CI): 0.88–1.54, reference: non-frail patients] in the adjusted analysis. Within the first year after mitral valve intervention, 42.8% of non-frail patients were never admitted, 42.1% were admitted for 1–14 days, 6.2% for 14–28 days, and 5.1% for >28 days. Among frail patients, the corresponding proportions were 26.6%, 46.3%, 9.1%, and 9.8%. In the adjusted analysis, frail patients were associated with higher odds of the composite outcome [odds ratio = 1.65 (95% CI: 1.37–2.00)]. Conclusion Frail patients were associated with more time spent in hospital within the first year following surgery compared with non-frail patients, but no statistically significant difference was found in the 1 year mortality according to frailty status in adjusted analysis.

Source: European Heart Journal Open

DOI: 10.1093/ehjopen/oeaf152