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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 ai...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10416912/ https://www.ncbi.nlm.nih.gov/pubmed/37568924 http://dx.doi.org/10.3390/diagnostics13152561 |
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author | Geers, Jolien Van den Bussche, Karen Vandeloo, Bert Kimenai, Dorien M. Van Loo, Ines Michiels, Vincent Plein, Daniele Beckers, Stefan Muylle, Teun Lieten, Siddhartha Cosyns, Bernard Compté, Nathalie Argacha, Jean-François |
author_facet | Geers, Jolien Van den Bussche, Karen Vandeloo, Bert Kimenai, Dorien M. Van Loo, Ines Michiels, Vincent Plein, Daniele Beckers, Stefan Muylle, Teun Lieten, Siddhartha Cosyns, Bernard Compté, Nathalie Argacha, Jean-François |
author_sort | Geers, Jolien |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-10416912 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-104169122023-08-12 Depression and Malnutrition for Prediction of Mortality after Transcatheter Aortic Valve Replacement: A Registry Study of a Tertiary Referral Hospital Geers, Jolien Van den Bussche, Karen Vandeloo, Bert Kimenai, Dorien M. Van Loo, Ines Michiels, Vincent Plein, Daniele Beckers, Stefan Muylle, Teun Lieten, Siddhartha Cosyns, Bernard Compté, Nathalie Argacha, Jean-François Diagnostics (Basel) Article 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. MDPI 2023-08-01 /pmc/articles/PMC10416912/ /pubmed/37568924 http://dx.doi.org/10.3390/diagnostics13152561 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Geers, Jolien Van den Bussche, Karen Vandeloo, Bert Kimenai, Dorien M. Van Loo, Ines Michiels, Vincent Plein, Daniele Beckers, Stefan Muylle, Teun Lieten, Siddhartha Cosyns, Bernard Compté, Nathalie Argacha, Jean-François Depression and Malnutrition for Prediction of Mortality after Transcatheter Aortic Valve Replacement: A Registry Study of a Tertiary Referral Hospital |
title | Depression and Malnutrition for Prediction of Mortality after Transcatheter Aortic Valve Replacement: A Registry Study of a Tertiary Referral Hospital |
title_full | Depression and Malnutrition for Prediction of Mortality after Transcatheter Aortic Valve Replacement: A Registry Study of a Tertiary Referral Hospital |
title_fullStr | Depression and Malnutrition for Prediction of Mortality after Transcatheter Aortic Valve Replacement: A Registry Study of a Tertiary Referral Hospital |
title_full_unstemmed | Depression and Malnutrition for Prediction of Mortality after Transcatheter Aortic Valve Replacement: A Registry Study of a Tertiary Referral Hospital |
title_short | Depression and Malnutrition for Prediction of Mortality after Transcatheter Aortic Valve Replacement: A Registry Study of a Tertiary Referral Hospital |
title_sort | depression and malnutrition for prediction of mortality after transcatheter aortic valve replacement: a registry study of a tertiary referral hospital |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10416912/ https://www.ncbi.nlm.nih.gov/pubmed/37568924 http://dx.doi.org/10.3390/diagnostics13152561 |
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