Morphometric and traditional frailty assessment in transcatheter aortic valve implantation
Why this work is in the frame
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Bibliographic record
Abstract
OBJECTIVES: Frailty is common amongst patients undergoing transcatheter aortic valve implantation (TAVI). The aim of this study was to determine the prognostic relevance of newer objective and traditional measures of frailty after TAVI. METHODS: Consecutive patients were identified from the Leeds Teaching Hospitals Trust TAVI database. Frailty was quantified objectively by measuring the total psoas muscle area (TPMA) on routine computer tomography scans and compared against Canadian Study of Health and Aging Clinical Frailty Score, Katz Index of independence in activities of daily living and Clinician Estimated Poor Mobility. Postintervention morbidity and mortality were examined between these scoring systems. RESULTS: The current study included 420 patients who had undergone TAVI between January 2013 and December 2015. Median clinical follow-up was 4.0 years (interquartile range 2.9-5.0). Standardized measurements of the TPMA were not associated with either postintervention morbidity or mortality. Only the Canadian Study of Health and Aging Clinical Frailty Score was associated with hospital stay (adjusted regression coefficient 0.70, 95% confidence interval 0.04-1.36, P = 0.038) and overall all-cause mortality (adjusted regression coefficient 1.26, 95% confidence interval 1.05-1.50, P = 0.013). There were no significant correlations between TPMA and any of the traditional frailty tools. CONCLUSION: We demonstrate TPMA to be a poor measure of patient frailty when compared with traditional methods of assessment which failed to predict postintervention outcomes. Furthermore, morphometric sarcopaenia correlated poorly with established measures of frailty.
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Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it