Abstract
Background The Short Physical Performance Battery (SPPB) test can easily evaluate lower limb function, and its reliability in patients with heart disease has been verified. This study aimed to examine whether the preoperative SPPB, a lower extremity frailty test, predicts hospitalization-associated disability (HAD), a complication linked to adverse long-term outcomes, after transcatheter aortic valve implantation (TAVI). Methodology We retrospectively studied 92 consecutive TAVI patients (median age = 85 years, 63% female) treated between 2019 and 2024. Pre-TAVI SPPB was administered within three days before the procedure and divided into frail (<9) and robust (≥9) groups. All patients received individualized rehabilitation (low‑ to moderate‑intensity walking or cycle ergometer, resistance training targeting major lower limb muscle groups, and functional activities of daily living practice; 40-60 minutes, ≥5 days/week) beginning postoperative day one to two. Propensity scores were calculated with age, sex, Charlson Comorbidity Index >2, postoperative ambulation day, estimated glomerular filtration rate, and Geriatric Nutritional Risk Index, and balanced by overlap weighting. Logistic regression (overlap-weighted only) tested the association between the SPPB group and HAD, defined as a ≥5-point decline in the Barthel Index from the preoperative baseline to discharge. Results HAD occurred in 26.1% of the study. Adjusted analysis showed no significant association between preoperative frailty status and HAD (adjusted odds ratio = 1.11, 95% confidence interval = 0.41-2.98, p = 0.83). Conclusions An SPPB score <9 did not independently predict HAD after TAVI. These findings suggest that SPPB alone may be insufficient for preoperative HAD risk stratification, and that a multidimensional assessment, potentially including baseline ADL capacity and postoperative activity monitoring, remains necessary to identify high-risk patients.