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Frailty and clinical outcomes following aortic valve replacement
BACKGROUND AND AIMS: The Norton score is a well‐known scale to assess frailty. Frailty and a low Norton score are associated with complications and mortality in hospitalized patients. We aimed to evaluate whether a low Norton score is associated with surgical complications and death after aortic val...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9544524/ https://www.ncbi.nlm.nih.gov/pubmed/35920838 http://dx.doi.org/10.1111/jocs.16801 |
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author | Ram, Eilon Peled, Yael Miller, Tali B. Dray, Efrat M. Karni, Ehud Raanani, Ehud Sternik, Leonid |
author_facet | Ram, Eilon Peled, Yael Miller, Tali B. Dray, Efrat M. Karni, Ehud Raanani, Ehud Sternik, Leonid |
author_sort | Ram, Eilon |
collection | PubMed |
description | BACKGROUND AND AIMS: The Norton score is a well‐known scale to assess frailty. Frailty and a low Norton score are associated with complications and mortality in hospitalized patients. We aimed to evaluate whether a low Norton score is associated with surgical complications and death after aortic valve replacement (AVR). METHODS: From 2004 through 2020, we performed an observational study in a large tertiary medical center, which included all patients who had undergone isolated AVR surgery. Of the 1469 study patients, 618 patients (42%) had a low (<18) and 851 patients (58%) a high Norton score (≥18). RESULTS: Frailer patients with a low Norton score had higher in‐hospital mortality compared to those with a high Norton score (5.5% vs. 0.8%, p < .001). The Norton score was significantly higher among patients who survived compared to those who died (17.5 ± 2.4 vs. 11.5 ± 5.2, p < .001). A low Norton score was associated with a threefold increased risk of in‐hospital mortality (odds ratio 3.03; 95% confidence interval [CI] 1.14–0.09, p = .034). Ten‐year mortality rate was higher among frailer patients with a low compared with a high Norton score (25.9%, 13.3%; hazard ratio 0.69, CI 0.48‐0.82, p < .001). By adding a Norton score to standard prognostic factors (age, gender, comorbidities, left ventricular ejection fraction, functional class) we showed a significant improvement of 59.4% (p < .001) for predicting 1‐year mortality, and 40.6% (p < .001) for predicting 10‐year mortality. CONCLUSIONS: Our findings show that the admission Norton score is a powerful marker of short‐ and long‐term mortality, and, therefore, should be considered as a risk stratification tool in patients who are candidates for AVR. |
format | Online Article Text |
id | pubmed-9544524 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-95445242022-10-14 Frailty and clinical outcomes following aortic valve replacement Ram, Eilon Peled, Yael Miller, Tali B. Dray, Efrat M. Karni, Ehud Raanani, Ehud Sternik, Leonid J Card Surg Original Articles BACKGROUND AND AIMS: The Norton score is a well‐known scale to assess frailty. Frailty and a low Norton score are associated with complications and mortality in hospitalized patients. We aimed to evaluate whether a low Norton score is associated with surgical complications and death after aortic valve replacement (AVR). METHODS: From 2004 through 2020, we performed an observational study in a large tertiary medical center, which included all patients who had undergone isolated AVR surgery. Of the 1469 study patients, 618 patients (42%) had a low (<18) and 851 patients (58%) a high Norton score (≥18). RESULTS: Frailer patients with a low Norton score had higher in‐hospital mortality compared to those with a high Norton score (5.5% vs. 0.8%, p < .001). The Norton score was significantly higher among patients who survived compared to those who died (17.5 ± 2.4 vs. 11.5 ± 5.2, p < .001). A low Norton score was associated with a threefold increased risk of in‐hospital mortality (odds ratio 3.03; 95% confidence interval [CI] 1.14–0.09, p = .034). Ten‐year mortality rate was higher among frailer patients with a low compared with a high Norton score (25.9%, 13.3%; hazard ratio 0.69, CI 0.48‐0.82, p < .001). By adding a Norton score to standard prognostic factors (age, gender, comorbidities, left ventricular ejection fraction, functional class) we showed a significant improvement of 59.4% (p < .001) for predicting 1‐year mortality, and 40.6% (p < .001) for predicting 10‐year mortality. CONCLUSIONS: Our findings show that the admission Norton score is a powerful marker of short‐ and long‐term mortality, and, therefore, should be considered as a risk stratification tool in patients who are candidates for AVR. John Wiley and Sons Inc. 2022-08-03 2022-10 /pmc/articles/PMC9544524/ /pubmed/35920838 http://dx.doi.org/10.1111/jocs.16801 Text en © 2022 The Authors. Journal of Cardiac Surgery published by Wiley Periodicals LLC. https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Articles Ram, Eilon Peled, Yael Miller, Tali B. Dray, Efrat M. Karni, Ehud Raanani, Ehud Sternik, Leonid Frailty and clinical outcomes following aortic valve replacement |
title | Frailty and clinical outcomes following aortic valve replacement |
title_full | Frailty and clinical outcomes following aortic valve replacement |
title_fullStr | Frailty and clinical outcomes following aortic valve replacement |
title_full_unstemmed | Frailty and clinical outcomes following aortic valve replacement |
title_short | Frailty and clinical outcomes following aortic valve replacement |
title_sort | frailty and clinical outcomes following aortic valve replacement |
topic | Original Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9544524/ https://www.ncbi.nlm.nih.gov/pubmed/35920838 http://dx.doi.org/10.1111/jocs.16801 |
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