Details der Publikation - Baseline frailty status and outcomes important for shared decision-making in older adults receiving transcatheter aortic valve implantation, a prospective observational study

Baseline frailty status and outcomes important for shared decision-making in older adults receiving transcatheter aortic valve implantation, a prospective observational study

Aims The objective of this study was to examine baseline frailty status (including cognitive deficits) and important clinical outcomes, to inform shared decision-making in older adults receiving transcatheter aortic valve implantation (TAVI). Methods and results We conducted a prospective, observational study of 82 TAVI patients, recruited 2013 to 2015, with 2-year follow-up. Mean age was 83 years (standard deviation (SD) 4.7). Eighteen percent of the patients were frail, as assessed with an 8-item frailty scale. Fifteen patients (18%) had a Mini-Mental Status Examination (MMSE) score below 24 points at baseline, indicating cognitive impairment or dementia and five patients had an MMSE below 20 points. Mean New York Heart Association (NYHA) class at baseline and 6 months was 2.5 (SD 0.6) and 1.4 (SD 0.6), (p < 0.001). There was no change in mean Nottingham Extended Activities of Daily Living (NEADL) scale between baseline and 6 months, 54.2 (SD 11.5) and 54.5 (SD 10.3) points, respectively, mean difference 0.3 (p = 0.7). At 2 years, six patients (7%) had died, four (5%, n = 79) lived in a nursing home, four (5%) suffered from disabling stroke, and six (7%) contracted infective endocarditis. Conclusions TAVI patients had improvement in symptoms and maintenance of activity of daily living at 6 months. They had low mortality and most patients lived in their own home 2 years after TAVI. Complications like death, stroke, and endocarditis occurred. Some patients had cognitive impairment before the procedure which might influence decision-making. Our findings may be used to develop pre-TAVI decision aids..

Medienart:	E-Artikel

Erscheinungsjahr:	2020
Erschienen:	2020

Enthalten in:	Zur Gesamtaufnahme - volume:33
Enthalten in:	Aging clinical and experimental research - 33(2020), 2 vom: 19. März, Seite 345-352

Sprache:	Englisch

Beteiligte Personen:	Skaar, Elisabeth [VerfasserIn] Øksnes, Anja [VerfasserIn] Eide, Leslie Sofia Pareja [VerfasserIn] Norekvål, Tone Merete [VerfasserIn] Ranhoff, Anette Hylen [VerfasserIn] Nordrehaug, Jan Erik [VerfasserIn] Forman, Daniel Edward [VerfasserIn] Schoenenberger, Andreas W. [VerfasserIn] Hufthammer, Karl Ove [VerfasserIn] Kuiper, Karel Kier-Jan [VerfasserIn] Bleie, Øyvind [VerfasserIn] Packer, Erik Jerome Stene [VerfasserIn] Langørgen, Jørund [VerfasserIn] Haaverstad, Rune [VerfasserIn] Schaufel, Margrethe Aase [VerfasserIn]

Links:	Volltext [kostenfrei]

Themen:	Activity of daily living Aortic stenosis Older adults Shared decision making TAVI

Anmerkungen:	© The Author(s) 2020

doi:	10.1007/s40520-020-01525-z

funding:
Förderinstitution / Projekttitel:

PPN (Katalog-ID):	OLC2124057391

Internformat


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520			\|a Aims The objective of this study was to examine baseline frailty status (including cognitive deficits) and important clinical outcomes, to inform shared decision-making in older adults receiving transcatheter aortic valve implantation (TAVI). Methods and results We conducted a prospective, observational study of 82 TAVI patients, recruited 2013 to 2015, with 2-year follow-up. Mean age was 83 years (standard deviation (SD) 4.7). Eighteen percent of the patients were frail, as assessed with an 8-item frailty scale. Fifteen patients (18%) had a Mini-Mental Status Examination (MMSE) score below 24 points at baseline, indicating cognitive impairment or dementia and five patients had an MMSE below 20 points. Mean New York Heart Association (NYHA) class at baseline and 6 months was 2.5 (SD 0.6) and 1.4 (SD 0.6), (p < 0.001). There was no change in mean Nottingham Extended Activities of Daily Living (NEADL) scale between baseline and 6 months, 54.2 (SD 11.5) and 54.5 (SD 10.3) points, respectively, mean difference 0.3 (p = 0.7). At 2 years, six patients (7%) had died, four (5%, n = 79) lived in a nursing home, four (5%) suffered from disabling stroke, and six (7%) contracted infective endocarditis. Conclusions TAVI patients had improvement in symptoms and maintenance of activity of daily living at 6 months. They had low mortality and most patients lived in their own home 2 years after TAVI. Complications like death, stroke, and endocarditis occurred. Some patients had cognitive impairment before the procedure which might influence decision-making. Our findings may be used to develop pre-TAVI decision aids.
650		4	\|a Aortic stenosis
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700	1		\|a Øksnes, Anja \|4 aut
700	1		\|a Eide, Leslie Sofia Pareja \|4 aut
700	1		\|a Norekvål, Tone Merete \|4 aut
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700	1		\|a Schoenenberger, Andreas W. \|4 aut
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700	1		\|a Bleie, Øyvind \|4 aut
700	1		\|a Packer, Erik Jerome Stene \|4 aut
700	1		\|a Langørgen, Jørund \|4 aut
700	1		\|a Haaverstad, Rune \|4 aut
700	1		\|a Schaufel, Margrethe Aase \|4 aut
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Baseline frailty status and outcomes important for shared decision-making in older adults receiving transcatheter aortic valve implantation, a prospective observational study

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