Table 2

Results of meta-analysis and GRADE assessment*

EffectsGRADE assessment
# included studyFrailty measures†# individuals# eventsEstimate (95% CI)Study designRisk of biasInconsistencyIndirectnessImprecisionOther considerationsCertainty
Procedural death
 6All95866547.60% (4.41% to 12.79%)ObservationalNot seriousStrongly seriousStrongly seriousNot seriousNoneVery low
30-day mortality
 13All23 62812367.32% (5.66% to 9.42%)ObservationalSeriousStrongly seriousStrongly seriousNot seriousNoneVery low
 8Multi13521138.58% (7.18% to 10.22%)ObservationalSeriousSeriousStrongly seriousNot seriousNoneVery low
 3Modified Fried407317.86% (5.20% to 11.70%)ObservationalSeriousNot seriousStrongly seriousSeriousNoneVery low
Cardiovascular death at 30 days
 2Single64532593.37% (1.93% to 5.81%)ObservationalSeriousSeriousStrongly seriousNot seriousNoneVery low
6-month mortality
 2Multi1873016.12% (11.50% to 22.13%)ObservationalSeriousSeriousStrongly seriousStrongly seriousNoneVery low
1-year mortality
 10All15 471315123.98% (20.71% to 27.58%)ObservationalSeriousStrongly seriousStrongly seriousNot seriousNoneVery low
 6Multi84519122.75% (20.03% to 25.71%)ObservationalSeriousSeriousStrongly seriousSeriousNoneVery low
 2Fried and modified Fried2236026.91% (21.50% to 33.11%)ObservationalSeriousSeriousStrongly seriousStrongly seriousNoneVery low
Survival
 17All48 258NA1-year survival: 75.6% (75.2% to 76.0%)ObservationalSeriousStrongly seriousStrongly seriousNot seriousNoneVery low
2-year survival: 65.0% (63.3% to 66.7%)
3-year survival: 48.7% (43.3% to 54.7%)
 4Fried and modified Fried484NA1-year survival: 73% (68.8% to 77.5%)ObservationalSeriousSeriousStrongly seriousStrongly seriousNoneVery low
2-year survival: 64.5% (56.4% to 73.9%)
3-year survival: 58.9% (49% to 70.9%)
Procedural acute kidney injury
 4Single654845811.34% (6.43% to 19.22%)ObservationalNot seriousStrongly seriousStrongly seriousNot seriousNoneVery low
Procedural cardiac tamponade
 3Single553173.19% (1.99% to 5.07%)ObservationalNot seriousSeriousStrongly seriousNot seriousNoneVery low
Convert to open heart surgery
 2All42593002.29% (0.49% to 9.91%)ObservationalNot seriousStrongly seriousStrongly seriousNot seriousNoneVery low
Procedural life-threatening bleeding
 5All653639.75% (7.69% to 12.29%)ObservationalNot seriousSeriousStrongly seriousNot seriousNoneVery low
Procedural major bleeding
 5Single8301048.53% (3.53% to 19.19%)ObservationalNot seriousStrongly seriousStrongly seriousNot seriousNoneVery low
Procedural minor bleeding
 4Single77414718.34% (10.66% to 29.73%)ObservationalNot seriousStrongly seriousStrongly seriousSeriousNoneVery low
Procedural major vascular complications
 3Single6476310.49% (4.76% to 21.54%)ObservationalSeriousStrongly seriousStrongly seriousNot seriousNoneVery low
30-day major vascular complications
 2All18972.97% (0.34% to 21.67%)ObservationalSeriousSeriousStrongly seriousNot seriousNoneVery low
Procedural minor vascular complications
 2Single591437.37% (3.24% to 15.93%)ObservationalSeriousStrongly seriousStrongly seriousNot seriousNoneVery low
Procedural major access-site complications
 3Single148159.44% (4.04% to 20.51%)ObservationalSeriousSeriousStrongly seriousStrongly seriousNoneVery low
Procedural permanent pacemaker
 7All36603658.12% (5.79% to 11.26%)ObservationalSeriousSeriousStrongly seriousNot seriousNoneVery low
Readmission within 30 days
 3Multi2482710.37% (3.75% to 25.59%)ObservationalSeriousStrongly seriousStrongly seriousStrongly seriousNoneVery low
Procedural stroke
 8All1756392.94% (1.76% to 4.88%)ObservationalStrongly seriousSeriousStrongly seriousNot seriousNoneVery low
Stroke within 30 days
 2Single61851322.14% (1.81% to 2.53%)ObservationalSeriousSeriousStrongly seriousNot seriousNoneVery low
Transfusion
 3All45819141.01% (34.02% to 48.39%)ObservationalSeriousSeriousStrongly seriousStrongly seriousNoneVery low
2-valve implantation
 2Single409102.46% (1.33% to 4.51%)ObservationalNot seriousSeriousStrongly seriousNot seriousNoneVery low
Length of hospitalisation
6All308NA8.25 (6.62 to 10.27)ObservationalStrongly seriousStrongly seriousStrongly seriousStrongly seriousNoneVery low

  • Single indicates single measures.

  • Multi indicates multimeasures.

  • Fried indicates the Fried phenotype.

  • Modified Fried indicates the modified Fried phenotype.

  • Fried and modified Fried includes the Fried phenotype and modified Fried phenotype.

  • All includes all single and multimeasures, including administrative database algorithms.

  • *Meta-analyses conducted using random-ffects model.

  • †Frailty measures are categorised as single, multimeasures, administrative data based, Fried, modified Fried and all.

  • GRADE, Grading of Recommendations, Assessment, Development and Evaluation.