Valvular & structural heart diseaseResearch article

Prevalence and Prognostic Significance of Frailty in Elderly Patients With Severe Valvular Heart Diseases

JACC AdvPublished

  • China-DVD2 Study

Authors' conclusion

Frailty is highly prevalent and independently associated with poor prognosis in severe VHD. The simplified 4-item frailty score offers a practical and incrementally valuable tool for enhancing risk stratification in routine clinical practice.

Study context

Population
Elderly patients with severe valvular heart disease (VHD)elderly patients with severe VHD from the China-DVD2 Study
Participants
2,147 patients
Comparison
Association between frailty and adverse clinical events; frailty score added to the European System for Cardiac Operative Risk Evaluation II
Outcome
All-cause death
Follow-up
1-year

Main finding

As reported in the abstract

Adjusted hazard ratio

1.50

95% CI 1.25–1.81

simplified frailty score
adjusted HR 1.50 (95% CI 1.25–1.81)

Secondary outcomes

All-cause death and heart failure hospitalization (secondary composite outcome) · 1-year

Comparisonadjusted HR (95% CI)
simplified frailty score · composite outcome1.53 (1.32–1.77)

Frailty and prefrailty prevalence

Frailty prevalence, depending on the assessment tool
16.8% to 39.3%
Prefrailty prevalence, depending on the assessment tool
50.9% to 64.5%

Exploratory subgroups and specific VHD subtypes

These associations were preserved across the exploratory subgroups and specific VHD subtypes

C-statistic, all-cause mortality: frailty score added to European System for Cardiac Operative Risk Evaluation II

C-statistic
0.715 vs 0.668
  • likelihood ratio test P < 0.001

C-statistic, composite outcome: frailty score added to European System for Cardiac Operative Risk Evaluation II

C-statistic
0.722 vs 0.688
  • likelihood ratio test P < 0.001

Original publication

Prevalence and Prognostic Significance of Frailty in Elderly Patients With Severe Valvular Heart Diseases. JACC Adv. Published 28 August 2026. doi:10.1016/j.jacadv.2026.103193

Summarised from the published abstract; every number is checked against it