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Frailty and treatment outcomes — RACP Adult Medicine MCQ

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HardEthics and public healthFrailty and treatment outcomesRACP Adult Medicine

An 89-year-old woman with severe aortic stenosis is assessed for transcatheter valve intervention. She has slow gait speed, unintentional weight loss, recurrent falls and needs help with bathing and dressing. Renal function and valve gradients are similar to other candidates. What is the most important prognostic factor?

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Correct answer: C — Frailty and baseline functional status

In older adults undergoing invasive treatment, frailty and functional status strongly predict mortality, complications and recovery beyond disease severity alone. Valve gradient matters for indication but not the whole prognosis. Chronological age, isolated sodium and murmur presence are less informative than multidimensional frailty.

Reference: Australian geriatric medicine guidance; CSANZ valve guidance