BACKGROUND: For selected patients with symptomatic aortic stenosis, transcatheter aortic valve implantation (TAVI) is an alternative to surgical aortic valve replacement (AVR). In addition to co-morbidities, frailty has to be taken into account in the decision-making process. Criteria for patient selection, according to current guidelines, include EuroSCORE and STS score but frailty is not easy to quantify. ISAR (Identification of Seniors At Risk) detects seniors at risk for adverse health outcome after an emergency visit and SHERPA (Score Hospitalier d'Evaluation du Risque de Perte d'Autonomie) assesses the risk of functional decline after hospitalization. OBJECTIVES: The aim of the present study was to evaluate the impact of ISAR and SHERPA scores in the prediction of patient outcome afterTAVI. METHODS AND RESULTS: A prospective cohort of 30 consecutive octogenarian patients (16 males, 86 +/- 3 y, EuroSCORE 34 +/- 12%) underwent a transfemoral TAVI and a complete geriatric assessment in our institution. Survival at one year was 73%. The ISAR score was similar between both groups (3.1 +/- 1 vs. 3.6 +/- 1; P = 0.10) but the SHERPA score was significantly higher in non-survivors (7.8 +/- 1.6) than among survivors (4.9 +/- 2.4; P = 0.001). With multivariate analysis, SHERPA score and BMI were independent predictors of 1-year mortality. Kaplan-Meier analysis showed that 1-year survival was significantly lower in patients with than in those without a SHERPA score > 7 (40 vs. 89%; P = 0.004). CONCLUSIONS: The result of this study showed that SHERPA score predicts 1-year survival after transfemoral TAVI and could be considered as a useful frailty score in patient selection.
BACKGROUND: For selected patients with symptomatic aortic stenosis, transcatheter aortic valve implantation (TAVI) is an alternative to surgical aortic valve replacement (AVR). In addition to co-morbidities, frailty has to be taken into account in the decision-making process. Criteria for patient selection, according to current guidelines, include EuroSCORE and STS score but frailty is not easy to quantify. ISAR (Identification of Seniors At Risk) detects seniors at risk for adverse health outcome after an emergency visit and SHERPA (Score Hospitalier d'Evaluation du Risque de Perte d'Autonomie) assesses the risk of functional decline after hospitalization. OBJECTIVES: The aim of the present study was to evaluate the impact of ISAR and SHERPA scores in the prediction of patient outcome afterTAVI. METHODS AND RESULTS: A prospective cohort of 30 consecutive octogenarian patients (16 males, 86 +/- 3 y, EuroSCORE 34 +/- 12%) underwent a transfemoral TAVI and a complete geriatric assessment in our institution. Survival at one year was 73%. The ISAR score was similar between both groups (3.1 +/- 1 vs. 3.6 +/- 1; P = 0.10) but the SHERPA score was significantly higher in non-survivors (7.8 +/- 1.6) than among survivors (4.9 +/- 2.4; P = 0.001). With multivariate analysis, SHERPA score and BMI were independent predictors of 1-year mortality. Kaplan-Meier analysis showed that 1-year survival was significantly lower in patients with than in those without a SHERPA score > 7 (40 vs. 89%; P = 0.004). CONCLUSIONS: The result of this study showed that SHERPA score predicts 1-year survival after transfemoral TAVI and could be considered as a useful frailty score in patient selection.
Authors: Valérie M Collas; Caroline M Van De Heyning; Bernard P Paelinck; Inez E Rodrigus; Christiaan J Vrints; Johan M Bosmans Journal: Interact Cardiovasc Thorac Surg Date: 2015-12-20
Authors: Andrea Ungar; Giulio Mannarino; Nathalie van der Velde; Jan Baan; Marie-Pierre Thibodeau; Jean-Bernard Masson; Gennaro Santoro; Martijn van Mourik; Sofie Jansen; Cornelia Deutsch; Peter Bramlage; Jana Kurucova; Martin Thoenes; Stefania Maggi; Andreas W Schoenenberger Journal: BMC Cardiovasc Disord Date: 2018-01-04 Impact factor: 2.298
Authors: Maisha M Khan; Krista L Lanctôt; Stephen E Fremes; Harindra C Wijeysundera; Sam Radhakrishnan; Damien Gallagher; Dov Gandell; Megan C Brenkel; Elias L Hazan; Natalia G Docteur; Nathan Herrmann Journal: Clin Interv Aging Date: 2019-05-08 Impact factor: 4.458
Authors: Atul Anand; Catherine Harley; Akila Visvanathan; Anoop S V Shah; Joanna Cowell; Alasdair MacLullich; Susan Shenkin; Nicholas L Mills Journal: Eur Heart J Qual Care Clin Outcomes Date: 2017-04-01