Impact of Frailty Markers for Unplanned Hospital Readmission Following Transcatheter Aortic Valve Implantation

Higuchi, Ryosuke; Tobaru, Tetsuya; Iguchi, Nobuo; Takanashi, Shuichiro; Takayama, Morimasa; Isobe, Mitsuaki

doi:10.1253/circj.cj-17-0816

Cited by 37 publications

(22 citation statements)

References 26 publications

(19 reference statements)

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“…Thus, it is only natural that recent past history is a powerful predictor for readmission in this population. Besides this, the next more relevant variable is the Fried aggregate frailty index, which is in agreement with recent literature where frailty has been found to predict hospital readmission and mortality in patients with heart failure (Rampersad et al, ), after Transcatheter Aortic Valve Implantation (Saji et al, ), with chronic obtrusive pulmonary disease (Bernabeu‐Mora et al, ), and in hip and knee arthroplasty (Shin et al, ; Traven et al, ). However, the definition of frailty indices are still a matter of debate.…”

Section: Discussionsupporting

confidence: 86%

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Modelling hospital readmissions under frailty conditions for healthy aging

et al. 2019

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In the current context of an aging population in many developed countries, the issue of healthy aging is at the forefront of the political, scientific, and technological concerns. The frailty accompanying the late years of elderly people (>70 years old) deserves special consideration due to its great economical and personal costs and the workload imposed on the health care system. Hospital readmissions under a short time after hospital discharge are one of the sources of concern, and much effort is being devoted to their prediction for better care of the elder and optimized resource management. In this paper, we consider the prediction of readmissions for patients that are evaluated positively in the frailty scales. The computational experiments are carried out over a gender‐balanced cohort of 645 patients recruited at the University Hospital of Alava. We report machine‐learning prediction results of the readmission before the standard readmission limit of 30 days. We apply an upsampling technique to correct for class imbalance. Results are positive, encouraging further research and the creation of larger cohorts in international efforts.

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Section: Discussionsupporting

confidence: 86%

“…Transcatheter Aortic Valve Implantation (Saji et al, 2018), with chronic obtrusive pulmonary disease (Bernabeu-Mora et al, 2017), and in hip and knee arthroplasty (Shin et al, 2016;Traven et al, 2019). However, the definition of frailty indices are still a matter of debate.…”

Section: Discussionmentioning

confidence: 99%

Modelling hospital readmissions under frailty conditions for healthy aging

et al. 2019

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“…Moreover, used methods were subjective and based on qualitative manner and could not precisely evaluate cognitive function and level of independence. Enhanced FFS (or 7-item expanded CHS) with additional testing of cognitive function (using Mini Mental State Examination (MMSE)) and depressed mood was implemented [ 24 , 27 ]. Another example of FFS modification (modified fried frailty criteria) was scale for frailty evaluation that includes similar domains by using different methods to describe malnutrition (hypoalbuminemia) and clearly describe level of independence with Katz index [ 13 , 28 – 30 ].…”

Section: Resultsmentioning

confidence: 99%

“…One of the requirements for frailty assessment (especially for screening) is simplicity and ability to assess frailty in a very short period of time. One of the most evaluated frailty assessments is the 5-meter (15 feet ~ 4,5 meters) walking test which can be used as part of other scales (FFS) or as stand-alone evaluation [ 13 , 20 , 24 , 27 , 30 , 47 , 49 – 51 ]. This test results could be evaluated in different manner: (1) measuring time taken for 5-meter walk in seconds and (2) measuring gait speed in meters per second.…”

Section: Resultsmentioning

confidence: 99%

Frailty and Exercise Training: How to Provide Best Care after Cardiac Surgery or Intervention for Elder Patients with Valvular Heart Disease

Tamulevičiūtė-Prascienė

Drulyte

Jurenaite

et al. 2018

BioMed Research International

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The aim of this literature review was to evaluate existing evidence on exercise-based cardiac rehabilitation (CR) as a treatment option for elderly frail patients with valvular heart disease (VHD). Pubmed database was searched for articles between 1980 and January 2018. From 2623 articles screened, 61 on frailty and VHD and 12 on exercise-based training for patients with VHD were included in the analysis. We studied and described frailty assessment in this patient population. Studies reporting results of exercise training in patients after surgical/interventional VHD treatment were analyzed regarding contents and outcomes. The tools for frailty assessment included fried phenotype frailty index and its modifications, multidimensional geriatric assessment, clinical frailty scale, 5-meter walking test, serum albumin levels, and Katz index of activities of daily living. Frailty assessment in CR settings should be based on functional, objective tests and should have similar components as tools for risk assessment (mobility, muscle mass and strength, independence in daily living, cognitive functions, nutrition, and anxiety and depression evaluation). Participating in comprehensive exercise-based CR could improve short- and long-term outcomes (better quality of life, physical and functional capacity) in frail VHD patients. Such CR program should be led by cardiologist, and its content should include (1) exercise training (endurance and strength training to improve muscle mass, strength, balance, and coordination), (2) nutrition counseling, (3) occupational therapy (to improve independency and cognitive function), (4) psychological counseling to ensure psychosocial health, and (5) social worker counseling (to improve independency). Comprehensive CR could help to prevent, restore, and reduce the severity of frailty as well as to improve outcomes for frail VHD patients after surgery or intervention.

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“…4,5,7,17 In the present study, BMI and low serum albumin level were identified as independent predictors of death, whereas the clinical frailty scale was not, probably because of its subjective parameters. 19,20 To enable accurate general use of any disease-specific predictive model, it is necessary to include objective parameters or information that is easy to obtain to minimize the inter-or intravariability. 18,21 Although the STS score consists of well-defined parameters, as with the SYNTAX score, its larger number of parameters than needed for the TAVR risk score may result in greater interobserver variability.…”

Section: Incremental Value Of the Tavr Risk Score With Af Bmi And Smentioning

confidence: 99%

Usefulness of the Transcatheter Aortic Valve Replacement Risk Score to Determine Mid-Term Outcomes

Tobaru

Higuchi

Mahara

et al. 2019

Circ J

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Impact of Frailty Markers for Unplanned Hospital Readmission Following Transcatheter Aortic Valve Implantation

Cited by 37 publications

References 26 publications

Modelling hospital readmissions under frailty conditions for healthy aging

Modelling hospital readmissions under frailty conditions for healthy aging

Frailty and Exercise Training: How to Provide Best Care after Cardiac Surgery or Intervention for Elder Patients with Valvular Heart Disease

Usefulness of the Transcatheter Aortic Valve Replacement Risk Score to Determine Mid-Term Outcomes

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