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Predictors of clinical outcome following transcatheter aortic valve implantation: a prospective cohort study

OBJECTIVE: In recent years, transcatheter aortic valve implantation (TAVI) has become the treatment of choice for patients with symptomatic aortic valve stenosis considered to be at increased or high surgical risk. The aim of this study was to identify predictors of postoperative adverse events in o...

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Autores principales: Dautzenberg, Lauren, Pals, Judith E M, Lefeber, Geert J, Stella, Pieter R, Abawi, Masieh, Emmelot-Vonk, Marielle, Koek, Huiberdina L
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8461740/
https://www.ncbi.nlm.nih.gov/pubmed/34556561
http://dx.doi.org/10.1136/openhrt-2021-001766
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author Dautzenberg, Lauren
Pals, Judith E M
Lefeber, Geert J
Stella, Pieter R
Abawi, Masieh
Emmelot-Vonk, Marielle
Koek, Huiberdina L
author_facet Dautzenberg, Lauren
Pals, Judith E M
Lefeber, Geert J
Stella, Pieter R
Abawi, Masieh
Emmelot-Vonk, Marielle
Koek, Huiberdina L
author_sort Dautzenberg, Lauren
collection PubMed
description OBJECTIVE: In recent years, transcatheter aortic valve implantation (TAVI) has become the treatment of choice for patients with symptomatic aortic valve stenosis considered to be at increased or high surgical risk. The aim of this study was to identify predictors of postoperative adverse events in older adults undergoing TAVI. METHODS: A prospective observational cohort study of patients who were referred to a geriatric outpatient clinic for a geriatric assessment prior to TAVI was conducted. The outcomes were mortality and hospital readmission within 3 months of TAVI and the occurrence of major postoperative complications during hospitalisation according to the Clavien-Dindo classification. These three outcomes were also combined to a composite outcome. Univariate and multivariate logistic regression analyses were performed to identify predictors of the outcomes and composite outcome of adverse events. RESULTS: This cohort included 490 patients who underwent TAVI (mean age 80.7±6.2 years, 47.3% male). Within 3 months of TAVI, 19 (3.9%) patients died and 46 (9.4%) patients experienced a hospital readmission. A total of 177 (36.1%) patients experienced one or more major complications according to the Clavien-Dindo classification during hospitalisation and 193 patients (39.4%) experienced the composite outcome of adverse events. In multivariate analyses, cognitive impairment was identified as an independent predictor of major postoperative complications (OR 2.16; 95% CI 1.14 to 4.19) and the composite outcome of adverse events (OR 2.40; 95% CI 1.21 to 4.79). No association was found between the other variables and the separate outcomes and composite outcome. CONCLUSION: Cognitive impairment is associated with postoperative adverse events in older patients undergoing TAVI. Therefore, it is important to screen for cognitive impairment prior to TAVI and it is recommended to include this in current TAVI guidelines.
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spelling pubmed-84617402021-10-08 Predictors of clinical outcome following transcatheter aortic valve implantation: a prospective cohort study Dautzenberg, Lauren Pals, Judith E M Lefeber, Geert J Stella, Pieter R Abawi, Masieh Emmelot-Vonk, Marielle Koek, Huiberdina L Open Heart Interventional Cardiology OBJECTIVE: In recent years, transcatheter aortic valve implantation (TAVI) has become the treatment of choice for patients with symptomatic aortic valve stenosis considered to be at increased or high surgical risk. The aim of this study was to identify predictors of postoperative adverse events in older adults undergoing TAVI. METHODS: A prospective observational cohort study of patients who were referred to a geriatric outpatient clinic for a geriatric assessment prior to TAVI was conducted. The outcomes were mortality and hospital readmission within 3 months of TAVI and the occurrence of major postoperative complications during hospitalisation according to the Clavien-Dindo classification. These three outcomes were also combined to a composite outcome. Univariate and multivariate logistic regression analyses were performed to identify predictors of the outcomes and composite outcome of adverse events. RESULTS: This cohort included 490 patients who underwent TAVI (mean age 80.7±6.2 years, 47.3% male). Within 3 months of TAVI, 19 (3.9%) patients died and 46 (9.4%) patients experienced a hospital readmission. A total of 177 (36.1%) patients experienced one or more major complications according to the Clavien-Dindo classification during hospitalisation and 193 patients (39.4%) experienced the composite outcome of adverse events. In multivariate analyses, cognitive impairment was identified as an independent predictor of major postoperative complications (OR 2.16; 95% CI 1.14 to 4.19) and the composite outcome of adverse events (OR 2.40; 95% CI 1.21 to 4.79). No association was found between the other variables and the separate outcomes and composite outcome. CONCLUSION: Cognitive impairment is associated with postoperative adverse events in older patients undergoing TAVI. Therefore, it is important to screen for cognitive impairment prior to TAVI and it is recommended to include this in current TAVI guidelines. BMJ Publishing Group 2021-09-23 /pmc/articles/PMC8461740/ /pubmed/34556561 http://dx.doi.org/10.1136/openhrt-2021-001766 Text en © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Interventional Cardiology
Dautzenberg, Lauren
Pals, Judith E M
Lefeber, Geert J
Stella, Pieter R
Abawi, Masieh
Emmelot-Vonk, Marielle
Koek, Huiberdina L
Predictors of clinical outcome following transcatheter aortic valve implantation: a prospective cohort study
title Predictors of clinical outcome following transcatheter aortic valve implantation: a prospective cohort study
title_full Predictors of clinical outcome following transcatheter aortic valve implantation: a prospective cohort study
title_fullStr Predictors of clinical outcome following transcatheter aortic valve implantation: a prospective cohort study
title_full_unstemmed Predictors of clinical outcome following transcatheter aortic valve implantation: a prospective cohort study
title_short Predictors of clinical outcome following transcatheter aortic valve implantation: a prospective cohort study
title_sort predictors of clinical outcome following transcatheter aortic valve implantation: a prospective cohort study
topic Interventional Cardiology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8461740/
https://www.ncbi.nlm.nih.gov/pubmed/34556561
http://dx.doi.org/10.1136/openhrt-2021-001766
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