Dhaval Chauhan1, Nicky Haik2, Aurelie Merlo3, Bruce J Haik4, Chunguang Chen5, Marc Cohen5, Anne Mosenthal6, Mark Russo7. 1. Department of Surgery, Rutgers - New Jersey Medical School, Newark, NJ; Cardiovascular Clinical Research Unit, Barnabas Heart Hospitals, NJ. Electronic address: dhavalchauhan86@gmail.com. 2. Cardiovascular Clinical Research Unit, Barnabas Heart Hospitals, NJ. 3. Cardiovascular Clinical Research Unit, Barnabas Heart Hospitals, NJ; Case Western Reserve University School of Medicine, Cleveland, OH. 4. Cardiovascular Clinical Research Unit, Barnabas Heart Hospitals, NJ; Department of Cardiology, Newark Beth Israel Medical Center, Newark, NJ. 5. Department of Cardiology, Newark Beth Israel Medical Center, Newark, NJ. 6. Department of Surgery, Rutgers - New Jersey Medical School, Newark, NJ. 7. Department of Surgery, Rutgers - New Jersey Medical School, Newark, NJ; Cardiovascular Clinical Research Unit, Barnabas Heart Hospitals, NJ.
Abstract
BACKGROUND: The purpose of this study is to assess the impact of frailty index comprised of commonly used frailty metrics on outcomes following transcatheter aortic valve replacement (TAVR) outcomes, including mortality, length of stay, and discharge destination. METHODS AND RESULTS: Retrospective data collection was performed for 342 consecutive patients who underwent TAVR at a single center from May 15, 2012, to September 17, 2015. Frailty index score was calculated using 15-ft walk test, Katz activities of daily living, preoperative serum albumin, and dominant handgrip strength. Patients were given a frailty score from 0/4 to 4/4, with higher scores indicating greater levels of frailty. There were 27 patients (8%) in 0/4, 82 patients (24%) in 1/4, 129 patients (38%) in 2/4, 73 patients (21%) in 3/4, and 31 patients (9%) in 4/4 frailty group. Multivariate cox, logistic, and linear regression analyses showed that patients with frailty score of 3/4 or 4/4 had increased all-cause mortality (P = .015 and P < .001) and were more likely to be discharged to an acute care facility (P = .083 and P = .001). 4/4 frail patients had increased post-operative length of stay (P = .014) when compared to less frail patients. Individual components of the frailty score were also independent predictors of all-cause mortality. Median survival in 4/4 frail patients was 7 months. CONCLUSIONS: Frailty index comprised of commonly used frailty metrics and its components are independent predictors of poor post-TAVR outcomes. There is a stepwise increase in mortality and post-TAVR length of stay with increasing frailty with dismal prognosis in extremely frail patients. Copyright Â
BACKGROUND: The purpose of this study is to assess the impact of frailty index comprised of commonly used frailty metrics on outcomes following transcatheter aortic valve replacement (TAVR) outcomes, including mortality, length of stay, and discharge destination. METHODS AND RESULTS: Retrospective data collection was performed for 342 consecutive patients who underwent TAVR at a single center from May 15, 2012, to September 17, 2015. Frailty index score was calculated using 15-ft walk test, Katz activities of daily living, preoperative serum albumin, and dominant handgrip strength. Patients were given a frailty score from 0/4 to 4/4, with higher scores indicating greater levels of frailty. There were 27 patients (8%) in 0/4, 82 patients (24%) in 1/4, 129 patients (38%) in 2/4, 73 patients (21%) in 3/4, and 31 patients (9%) in 4/4 frailty group. Multivariate cox, logistic, and linear regression analyses showed that patients with frailty score of 3/4 or 4/4 had increased all-cause mortality (P = .015 and P < .001) and were more likely to be discharged to an acute care facility (P = .083 and P = .001). 4/4 frail patients had increased post-operative length of stay (P = .014) when compared to less frail patients. Individual components of the frailty score were also independent predictors of all-cause mortality. Median survival in 4/4 frail patients was 7 months. CONCLUSIONS: Frailty index comprised of commonly used frailty metrics and its components are independent predictors of poor post-TAVR outcomes. There is a stepwise increase in mortality and post-TAVR length of stay with increasing frailty with dismal prognosis in extremely frail patients. Copyright Â
Authors: Sandra Shi; Jonathan Afilalo; Lewis A Lipsitz; Jeffrey J Popma; Kamal R Khabbaz; Roger J Laham; Kim Guibone; Francine Grodstein; Eliah Lux; Dae Hyun Kim Journal: J Gerontol A Biol Sci Med Sci Date: 2019-07-12 Impact factor: 6.053
Authors: Dennis van Erck; Christine D Dolman; Jacqueline Limpens; Wilma J M Scholte Op Reimer; José P Henriques; Ronak Delewi; Josje D Schoufour Journal: Age Ageing Date: 2022-09-02 Impact factor: 12.782