Impact of frailty on short- and long-term morbidity and mortality after transcatheter aortic valve implantation: risk assessment by Katz Index of activities of daily living

Puls, Miriam; Sobisiak, Bettina; Bleckmann, Annalen; Jacobshagen, Claudius; Danner, Bernhard C.; Hünlich, Mark; Beißbarth, Tim; Schöndube, Friedrich A.; Hasenfuß, Gerd; Seipelt, Ralf; Schillinger, Wolfgang

doi:10.4244/eijy14m08_03

Cited by 126 publications

(105 citation statements)

References 27 publications

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“…Suggested criteria for the diagnosis of frailty included 5 min walking time, grip strength, BMI <20 kg/m 2 and/or weight loss of 5 kg/year, serum albumin<3.5 g/dL, and cognitive impairment or dementia. Frailty was hence found to be a strong predictor of mortality and adverse outcomes following cardiac surgery and TAVI [26][27][28]. In this study, the authors found frailty to be present in 21.5% of obese patients vs 44.7% of patients with normal weight (p < 0.001).…”

Section: Discussionsupporting

confidence: 50%

Impact of body mass index on the outcomes following transcatheter aortic valve implantation

Abramowitz¹,

Chakravarty²,

Jilaihawi³

et al. 2016

Cathet Cardio Intervent

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Section: Discussionsupporting

confidence: 50%

Impact of body mass index on the outcomes following transcatheter aortic valve implantation

Abramowitz¹,

Chakravarty²,

Jilaihawi³

et al. 2016

Cathet Cardio Intervent

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“…Finally, 2 other small studies of 100 to 200 patients also found higher mortality in frail patients after adjustment. 21,22 Our study demonstrates the average gait speed observed in a large TAVR cohort and confirms the utility of gait speed as a single marker of frailty. The slowest walkers were older, more often female, and obese, with a higher prevalence of previous stroke, chronic lung disease, and heart failure.…”

Section: Discussionmentioning

confidence: 56%

Gait Speed Predicts 30-Day Mortality After Transcatheter Aortic Valve Replacement

et al. 2016

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Gait speed, alone or incorporated into geriatric rating scales, is associated with mortality among community-dwelling individuals, 10 patients with coronary heart disease, 11 elderly patients with heart failure, 12 and those undergoing cardiac surgery, including aortic valve replacement.13 Nevertheless, the association between slow gait speed (which is an indicator of physical frailty) and outcomes after TAVR in US Background-Surgical risk scores do not include frailty assessments (eg, gait speed), which are of particular importance for patients with severe aortic stenosis considering transcatheter aortic valve replacement. Methods and Results-We assessed the association of 5-m gait speed with outcomes in a cohort of 8039 patients who underwent transcatheter aortic valve replacement (November 2011-June 2014) and were included in the Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy Registry. We evaluated the association between continuous and categorical gait speed and 30-day all-cause mortality before and after adjustment for Society of Thoracic Surgeons-predicted risk of mortality score and key variables. Secondary outcomes included in-hospital mortality, bleeding, acute kidney injury, and stroke. The overall median gait speed was 0.63 m/s (25th-75th percentile, 0.47-0.79 m/s), with the slowest walkers (<0.5 m/s) constituting 28%, slow walkers (0.5-0.83 m/s) making up 48%, and normal walkers (>0.83 m/s) constituting 24% of the population. Thirty-day all-cause mortality rates were 8.4%, 6.6%, and 5.4% for the slowest, slow, and normal walkers, respectively (P<0.001). Each 0.2-m/s decrease in gait speed corresponded to an 11% increase in 30-day mortality (adjusted odds ratio, 1.11; 95% confidence interval, 1.01-1.22). The slowest walkers had 35% higher 30-day mortality than normal walkers (adjusted odds ratio, 1.35; 95% confidence interval, 1.01-1.80), significantly longer hospital stays, and a lower probability of being discharged to home. Conclusions-Gait

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“…La evaluación de la fragilidad no debe partir de un enfoque subjetivo, como una evaluación rápida y superficial, sino de la combinación de una serie de determinaciones objetivas. Actualmente están disponibles varias herramientas para evaluar la fragilidad 23,26,27 .…”

Section: Consideraciones Especiales Con Pacientes Ancianosunclassified

Guía ESC/EACTS 2017 sobre el tratamiento de las valvulopatías

Baumgartner¹,

Falk²,

Bax³

et al. 2018

Revista Española de Cardiología

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Impact of frailty on short- and long-term morbidity and mortality after transcatheter aortic valve implantation: risk assessment by Katz Index of activities of daily living

Cited by 126 publications

References 27 publications

Impact of body mass index on the outcomes following transcatheter aortic valve implantation

Impact of body mass index on the outcomes following transcatheter aortic valve implantation

Gait Speed Predicts 30-Day Mortality After Transcatheter Aortic Valve Replacement

Guía ESC/EACTS 2017 sobre el tratamiento de las valvulopatías

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