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Issue: Vol. 57
Section: Research Article
DOI: 10.47972/vjcts.v57i.1897
Date Published: 29/10/2026
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Nguyen, T. L., Trinh, V. H., & Pham, M. T. (2026). Predictive value of the clinical frailty scale and the essential frailty toolset versus euroscore ii for 30-day outcomes after mitral valve surgery. The Vietnam Journal of Cardiovascular and Thoracic Surgery, 57, 127-137. https://doi.org/10.47972/vjcts.v57i.1897

Predictive value of the clinical frailty scale and the essential frailty toolset versus euroscore ii for 30-day outcomes after mitral valve surgery

Thi Lieu Nguyen1, Viet Ha Trinh1,2, , Minh Tuan Pham
1 Hanoi Medical University
2 Vietnam National Heart Institute

Main Article Content

Abstract

Background: Frailty reflects reduced physiological reserve and may add prognostic information beyond conventional surgical risk scores. We compared the 30-day predictive performance of the Clinical Frailty Scale (CFS) and the Essential Frailty Toolset (EFT) with EuroSCORE II in patients undergoing mitral valve surgery.


Methods: Prospective cohort of 184 patients undergoing mitral valve repair or replacement at the Vietnam National Heart Institute, Bach Mai Hospital (September 2025 to July 2026). The primary endpoint was a 30-day composite of death, major cardiovascular complications, prolonged ventilation or reintubation, prolonged vasopressor dependence, and rehospitalization for heart failure. Discrimination was compared using DeLong's test.


Results: Mean age was 56.7 ± 9.8 years and 64.1% were women. Frailty was identified in 55.4% by CFS and 8.7% by EFT; only 16 of 102 patients frail by CFS were concordantly classified by EFT. The composite endpoint occurred in 107 patients (58.2%), with no deaths. Event rates rose across the three strata of all tools (p for trend < 0.001). The area under the curve was 0.809 (95% CI 0.750–0.868) for CFS, higher than EFT (0.736; p = 0.031) and EuroSCORE II (0.649; p < 0.001).


Conclusions: In a relatively young mitral valve population largely classified as low risk by EuroSCORE II, frailty assessment by CFS or EFT predicted 30-day outcomes better than EuroSCORE II; CFS showed the highest discriminative ability.

Keywords

Frailty, Clinical Frailty Scale, Essential Frailty Toolset, EuroSCORE II, Mitral valve surgery, 30-day composite outcome

Article Details

References

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