Depression and Malnutrition for Prediction of Mortality after Transcatheter Aortic Valve Replacement : A Registry Study of a Tertiary Referral Hospital
Moderate to severe frailty is a predictor of a poor outcome after transcatheter aortic valve replacement (TAVR), but little is known about the prognostic importance of different geriatric frailty markers in an overall fit or pre-frail geriatric population undergoing TAVR. This retrospective study aimed to examine the incremental value of adding patient frailty markers to conventional surgical risk score to predict all-cause mortality in relatively fit elderly patients undergoing TAVR. Overall patient frailty was assessed using the comprehensive geriatric assessment frailty index (CGA-FI). Multivariable Cox regression models were used to evaluate relationships of different geriatric frailty markers with all-cause mortality and single and combined frailty models were compared to a baseline model that included EuroSCORE II factors. One hundred relatively fit geriatric patients (84 ± 4 years old, mean CGA-FI 0.14 ± 0.05) were included, and 28% died during a median follow-up of 24 months. After adjustment, risk of depression (geriatric depression scale 15 (GDS-15)) and malnutrition remained significantly associated with all-cause mortality (HR 4.381, 95% CI 1.787-10.743; p = 0.001 and HR 3.076, 95% CI 1.151-8.217; p = 0.025, respectively). A combined frailty marker model including both GDS-15 and malnutrition on top of EuroSCORE II improved the discriminative ability to predict all-cause mortality (change in c-index: + 0.044). Screening for those frailty markers on top of the traditionally used EuroSCORE II may improve risk stratification and prognosis in relatively fit geriatric patients undergoing TAVR.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:13 |
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| Enthalten in: |
Diagnostics (Basel, Switzerland) - 13(2023), 15 vom: 01. Aug. |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Geers, Jolien [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Revised 14.08.2023 published: Electronic Citation Status PubMed-not-MEDLINE |
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| doi: |
10.3390/diagnostics13152561 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| 520 | |a Moderate to severe frailty is a predictor of a poor outcome after transcatheter aortic valve replacement (TAVR), but little is known about the prognostic importance of different geriatric frailty markers in an overall fit or pre-frail geriatric population undergoing TAVR. This retrospective study aimed to examine the incremental value of adding patient frailty markers to conventional surgical risk score to predict all-cause mortality in relatively fit elderly patients undergoing TAVR. Overall patient frailty was assessed using the comprehensive geriatric assessment frailty index (CGA-FI). Multivariable Cox regression models were used to evaluate relationships of different geriatric frailty markers with all-cause mortality and single and combined frailty models were compared to a baseline model that included EuroSCORE II factors. One hundred relatively fit geriatric patients (84 ± 4 years old, mean CGA-FI 0.14 ± 0.05) were included, and 28% died during a median follow-up of 24 months. After adjustment, risk of depression (geriatric depression scale 15 (GDS-15)) and malnutrition remained significantly associated with all-cause mortality (HR 4.381, 95% CI 1.787-10.743; p = 0.001 and HR 3.076, 95% CI 1.151-8.217; p = 0.025, respectively). A combined frailty marker model including both GDS-15 and malnutrition on top of EuroSCORE II improved the discriminative ability to predict all-cause mortality (change in c-index: + 0.044). Screening for those frailty markers on top of the traditionally used EuroSCORE II may improve risk stratification and prognosis in relatively fit geriatric patients undergoing TAVR | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a TAVR | |
| 650 | 4 | |a depression | |
| 650 | 4 | |a frailty | |
| 650 | 4 | |a malnutrition | |
| 700 | 1 | |a Van den Bussche, Karen |e verfasserin |4 aut | |
| 700 | 1 | |a Vandeloo, Bert |e verfasserin |4 aut | |
| 700 | 1 | |a Kimenai, Dorien M |e verfasserin |4 aut | |
| 700 | 1 | |a Van Loo, Ines |e verfasserin |4 aut | |
| 700 | 1 | |a Michiels, Vincent |e verfasserin |4 aut | |
| 700 | 1 | |a Plein, Daniele |e verfasserin |4 aut | |
| 700 | 1 | |a Beckers, Stefan |e verfasserin |4 aut | |
| 700 | 1 | |a Muylle, Teun |e verfasserin |4 aut | |
| 700 | 1 | |a Lieten, Siddhartha |e verfasserin |4 aut | |
| 700 | 1 | |a Cosyns, Bernard |e verfasserin |4 aut | |
| 700 | 1 | |a Compté, Nathalie |e verfasserin |4 aut | |
| 700 | 1 | |a Argacha, Jean-François |e verfasserin |4 aut | |
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