The Effect and Relationship of Frailty Indices on Survival After Transcatheter Aortic Valve Replacement
This study sought to evaluate the ability of individual markers of frailty to predict outcomes after transcatheter aortic valve replacement (TAVR) and of their discriminatory value in different age groups. Appropriate patient selection for TAVR remains a dilemma, especially among the most elderly an...
Gespeichert in:
| Veröffentlicht in: | JACC. Cardiovascular interventions 2020-01, Vol.13 (2), p.219-231 |
|---|---|
| Hauptverfasser: | , , , , , , , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 231 |
|---|---|
| container_issue | 2 |
| container_start_page | 219 |
| container_title | JACC. Cardiovascular interventions |
| container_volume | 13 |
| creator | Kiani, Soroosh Stebbins, Amanda Thourani, Vinod H. Forcillo, Jessica Vemulapalli, Sreekanth Kosinski, Andrzej S. Babaliaros, Vasilis Cohen, David Kodali, Susheel K. Kirtane, Ajay J. Hermiller, James B. Stewart, James Lowenstern, Angela Mack, Michael J. Guyton, Robert A. Devireddy, Chandan |
| description | This study sought to evaluate the ability of individual markers of frailty to predict outcomes after transcatheter aortic valve replacement (TAVR) and of their discriminatory value in different age groups.
Appropriate patient selection for TAVR remains a dilemma, especially among the most elderly and potentially frail.
The study evaluated patients ≥65 years of age in the Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy registry, linked to Centers for Medicare and Medicaid administrative claims data, receiving elective TAVR from November 2011 to June 2016 (n = 36,242). Indices of frailty included anemia, albumin level, and 5-m walk speed. We performed Cox proportional hazards regression for 30-day and 1-year mortality, adjusting for risk factors known to be predictive of 30-day mortality in the Transcatheter Valve Therapy registry, as well as survival analysis.
These indices are independently associated with mortality at 30 days and 1 year and provide incremental value in risk stratification for mortality, with low albumin providing the largest value (hazard ratio: 1.52). Those with low albumin and slower walking speed had longer lengths of stay and higher rates of bleeding and readmission (p |
| doi_str_mv | 10.1016/j.jcin.2019.08.015 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2344276924</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S1936879819317522</els_id><sourcerecordid>2344276924</sourcerecordid><originalsourceid>FETCH-LOGICAL-c466t-4dffd71d97624dc34f546e83a15e2c23118337ac00b98ec52aa586ff8fc2d70b3</originalsourceid><addsrcrecordid>eNp9kMtqGzEUhkVpadK0L9BF0bKbmegyowt0Y0KSBgKB1O1WyNIR1jDWuJJsyNv4WfxkHeO0y67OOfD9P5wPoc-UtJRQcT20g4upZYTqlqiW0P4NuqRKikYK0r-dd81Fo6RWF-hDKQMhgmjJ3qMLTrXkUveXaFiuAd-GAK5imzx-htHWOKWyjls8BXyXbRzry_HwkHx0UPCU8I9d3se9HfEiVMh4mW0qztY1nK7FlGt0x8MvO-7heHiG7WgdbCDVj-hdsGOBT6_zCv28u13efG8en-4fbhaPjeuEqE3nQ_CSei0F67zjXeg7AYpb2gNzjFOqOJfWEbLSClzPrO2VCEEFx7wkK36Fvp57t3n6vYNSzSYWB-NoE0y7YhjvOiaFZt2MsjPq8lRKhmC2OW5sfjGUmJNjM5iTY3NybIgys-M59OW1f7fagP8X-St1Br6dAZi_3EfIprgIyYGPefZs_BT_1_8H5HqQ9g</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2344276924</pqid></control><display><type>article</type><title>The Effect and Relationship of Frailty Indices on Survival After Transcatheter Aortic Valve Replacement</title><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>ScienceDirect Journals (5 years ago - present)</source><creator>Kiani, Soroosh ; Stebbins, Amanda ; Thourani, Vinod H. ; Forcillo, Jessica ; Vemulapalli, Sreekanth ; Kosinski, Andrzej S. ; Babaliaros, Vasilis ; Cohen, David ; Kodali, Susheel K. ; Kirtane, Ajay J. ; Hermiller, James B. ; Stewart, James ; Lowenstern, Angela ; Mack, Michael J. ; Guyton, Robert A. ; Devireddy, Chandan</creator><creatorcontrib>Kiani, Soroosh ; Stebbins, Amanda ; Thourani, Vinod H. ; Forcillo, Jessica ; Vemulapalli, Sreekanth ; Kosinski, Andrzej S. ; Babaliaros, Vasilis ; Cohen, David ; Kodali, Susheel K. ; Kirtane, Ajay J. ; Hermiller, James B. ; Stewart, James ; Lowenstern, Angela ; Mack, Michael J. ; Guyton, Robert A. ; Devireddy, Chandan ; STS/ACC TVT Registry</creatorcontrib><description>This study sought to evaluate the ability of individual markers of frailty to predict outcomes after transcatheter aortic valve replacement (TAVR) and of their discriminatory value in different age groups.
Appropriate patient selection for TAVR remains a dilemma, especially among the most elderly and potentially frail.
The study evaluated patients ≥65 years of age in the Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy registry, linked to Centers for Medicare and Medicaid administrative claims data, receiving elective TAVR from November 2011 to June 2016 (n = 36,242). Indices of frailty included anemia, albumin level, and 5-m walk speed. We performed Cox proportional hazards regression for 30-day and 1-year mortality, adjusting for risk factors known to be predictive of 30-day mortality in the Transcatheter Valve Therapy registry, as well as survival analysis.
These indices are independently associated with mortality at 30 days and 1 year and provide incremental value in risk stratification for mortality, with low albumin providing the largest value (hazard ratio: 1.52). Those with low albumin and slower walking speed had longer lengths of stay and higher rates of bleeding and readmission (p < 0.001). Those with anemia also had higher rates of bleeding, readmission, and subsequent myocardial infarction (p < 0.001).
This represents the largest study to date of the role of frailty indices after TAVR, further facilitating robust modeling and adjusting for a large number of confounders. These simple indices are easily attainable, and clinically relevant markers of frailty that may meaningfully stratify patients at risk for mortality after TAVR.
[Display omitted]</description><identifier>ISSN: 1936-8798</identifier><identifier>EISSN: 1876-7605</identifier><identifier>DOI: 10.1016/j.jcin.2019.08.015</identifier><identifier>PMID: 31973795</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>patient selection ; risk score ; TAVR</subject><ispartof>JACC. Cardiovascular interventions, 2020-01, Vol.13 (2), p.219-231</ispartof><rights>2020 American College of Cardiology Foundation</rights><rights>Copyright © 2020 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c466t-4dffd71d97624dc34f546e83a15e2c23118337ac00b98ec52aa586ff8fc2d70b3</citedby><cites>FETCH-LOGICAL-c466t-4dffd71d97624dc34f546e83a15e2c23118337ac00b98ec52aa586ff8fc2d70b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jcin.2019.08.015$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3536,27903,27904,45974</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31973795$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kiani, Soroosh</creatorcontrib><creatorcontrib>Stebbins, Amanda</creatorcontrib><creatorcontrib>Thourani, Vinod H.</creatorcontrib><creatorcontrib>Forcillo, Jessica</creatorcontrib><creatorcontrib>Vemulapalli, Sreekanth</creatorcontrib><creatorcontrib>Kosinski, Andrzej S.</creatorcontrib><creatorcontrib>Babaliaros, Vasilis</creatorcontrib><creatorcontrib>Cohen, David</creatorcontrib><creatorcontrib>Kodali, Susheel K.</creatorcontrib><creatorcontrib>Kirtane, Ajay J.</creatorcontrib><creatorcontrib>Hermiller, James B.</creatorcontrib><creatorcontrib>Stewart, James</creatorcontrib><creatorcontrib>Lowenstern, Angela</creatorcontrib><creatorcontrib>Mack, Michael J.</creatorcontrib><creatorcontrib>Guyton, Robert A.</creatorcontrib><creatorcontrib>Devireddy, Chandan</creatorcontrib><creatorcontrib>STS/ACC TVT Registry</creatorcontrib><title>The Effect and Relationship of Frailty Indices on Survival After Transcatheter Aortic Valve Replacement</title><title>JACC. Cardiovascular interventions</title><addtitle>JACC Cardiovasc Interv</addtitle><description>This study sought to evaluate the ability of individual markers of frailty to predict outcomes after transcatheter aortic valve replacement (TAVR) and of their discriminatory value in different age groups.
Appropriate patient selection for TAVR remains a dilemma, especially among the most elderly and potentially frail.
The study evaluated patients ≥65 years of age in the Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy registry, linked to Centers for Medicare and Medicaid administrative claims data, receiving elective TAVR from November 2011 to June 2016 (n = 36,242). Indices of frailty included anemia, albumin level, and 5-m walk speed. We performed Cox proportional hazards regression for 30-day and 1-year mortality, adjusting for risk factors known to be predictive of 30-day mortality in the Transcatheter Valve Therapy registry, as well as survival analysis.
These indices are independently associated with mortality at 30 days and 1 year and provide incremental value in risk stratification for mortality, with low albumin providing the largest value (hazard ratio: 1.52). Those with low albumin and slower walking speed had longer lengths of stay and higher rates of bleeding and readmission (p < 0.001). Those with anemia also had higher rates of bleeding, readmission, and subsequent myocardial infarction (p < 0.001).
This represents the largest study to date of the role of frailty indices after TAVR, further facilitating robust modeling and adjusting for a large number of confounders. These simple indices are easily attainable, and clinically relevant markers of frailty that may meaningfully stratify patients at risk for mortality after TAVR.
[Display omitted]</description><subject>patient selection</subject><subject>risk score</subject><subject>TAVR</subject><issn>1936-8798</issn><issn>1876-7605</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><recordid>eNp9kMtqGzEUhkVpadK0L9BF0bKbmegyowt0Y0KSBgKB1O1WyNIR1jDWuJJsyNv4WfxkHeO0y67OOfD9P5wPoc-UtJRQcT20g4upZYTqlqiW0P4NuqRKikYK0r-dd81Fo6RWF-hDKQMhgmjJ3qMLTrXkUveXaFiuAd-GAK5imzx-htHWOKWyjls8BXyXbRzry_HwkHx0UPCU8I9d3se9HfEiVMh4mW0qztY1nK7FlGt0x8MvO-7heHiG7WgdbCDVj-hdsGOBT6_zCv28u13efG8en-4fbhaPjeuEqE3nQ_CSei0F67zjXeg7AYpb2gNzjFOqOJfWEbLSClzPrO2VCEEFx7wkK36Fvp57t3n6vYNSzSYWB-NoE0y7YhjvOiaFZt2MsjPq8lRKhmC2OW5sfjGUmJNjM5iTY3NybIgys-M59OW1f7fagP8X-St1Br6dAZi_3EfIprgIyYGPefZs_BT_1_8H5HqQ9g</recordid><startdate>20200127</startdate><enddate>20200127</enddate><creator>Kiani, Soroosh</creator><creator>Stebbins, Amanda</creator><creator>Thourani, Vinod H.</creator><creator>Forcillo, Jessica</creator><creator>Vemulapalli, Sreekanth</creator><creator>Kosinski, Andrzej S.</creator><creator>Babaliaros, Vasilis</creator><creator>Cohen, David</creator><creator>Kodali, Susheel K.</creator><creator>Kirtane, Ajay J.</creator><creator>Hermiller, James B.</creator><creator>Stewart, James</creator><creator>Lowenstern, Angela</creator><creator>Mack, Michael J.</creator><creator>Guyton, Robert A.</creator><creator>Devireddy, Chandan</creator><general>Elsevier Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20200127</creationdate><title>The Effect and Relationship of Frailty Indices on Survival After Transcatheter Aortic Valve Replacement</title><author>Kiani, Soroosh ; Stebbins, Amanda ; Thourani, Vinod H. ; Forcillo, Jessica ; Vemulapalli, Sreekanth ; Kosinski, Andrzej S. ; Babaliaros, Vasilis ; Cohen, David ; Kodali, Susheel K. ; Kirtane, Ajay J. ; Hermiller, James B. ; Stewart, James ; Lowenstern, Angela ; Mack, Michael J. ; Guyton, Robert A. ; Devireddy, Chandan</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c466t-4dffd71d97624dc34f546e83a15e2c23118337ac00b98ec52aa586ff8fc2d70b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>patient selection</topic><topic>risk score</topic><topic>TAVR</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kiani, Soroosh</creatorcontrib><creatorcontrib>Stebbins, Amanda</creatorcontrib><creatorcontrib>Thourani, Vinod H.</creatorcontrib><creatorcontrib>Forcillo, Jessica</creatorcontrib><creatorcontrib>Vemulapalli, Sreekanth</creatorcontrib><creatorcontrib>Kosinski, Andrzej S.</creatorcontrib><creatorcontrib>Babaliaros, Vasilis</creatorcontrib><creatorcontrib>Cohen, David</creatorcontrib><creatorcontrib>Kodali, Susheel K.</creatorcontrib><creatorcontrib>Kirtane, Ajay J.</creatorcontrib><creatorcontrib>Hermiller, James B.</creatorcontrib><creatorcontrib>Stewart, James</creatorcontrib><creatorcontrib>Lowenstern, Angela</creatorcontrib><creatorcontrib>Mack, Michael J.</creatorcontrib><creatorcontrib>Guyton, Robert A.</creatorcontrib><creatorcontrib>Devireddy, Chandan</creatorcontrib><creatorcontrib>STS/ACC TVT Registry</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>JACC. Cardiovascular interventions</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kiani, Soroosh</au><au>Stebbins, Amanda</au><au>Thourani, Vinod H.</au><au>Forcillo, Jessica</au><au>Vemulapalli, Sreekanth</au><au>Kosinski, Andrzej S.</au><au>Babaliaros, Vasilis</au><au>Cohen, David</au><au>Kodali, Susheel K.</au><au>Kirtane, Ajay J.</au><au>Hermiller, James B.</au><au>Stewart, James</au><au>Lowenstern, Angela</au><au>Mack, Michael J.</au><au>Guyton, Robert A.</au><au>Devireddy, Chandan</au><aucorp>STS/ACC TVT Registry</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The Effect and Relationship of Frailty Indices on Survival After Transcatheter Aortic Valve Replacement</atitle><jtitle>JACC. Cardiovascular interventions</jtitle><addtitle>JACC Cardiovasc Interv</addtitle><date>2020-01-27</date><risdate>2020</risdate><volume>13</volume><issue>2</issue><spage>219</spage><epage>231</epage><pages>219-231</pages><issn>1936-8798</issn><eissn>1876-7605</eissn><abstract>This study sought to evaluate the ability of individual markers of frailty to predict outcomes after transcatheter aortic valve replacement (TAVR) and of their discriminatory value in different age groups.
Appropriate patient selection for TAVR remains a dilemma, especially among the most elderly and potentially frail.
The study evaluated patients ≥65 years of age in the Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy registry, linked to Centers for Medicare and Medicaid administrative claims data, receiving elective TAVR from November 2011 to June 2016 (n = 36,242). Indices of frailty included anemia, albumin level, and 5-m walk speed. We performed Cox proportional hazards regression for 30-day and 1-year mortality, adjusting for risk factors known to be predictive of 30-day mortality in the Transcatheter Valve Therapy registry, as well as survival analysis.
These indices are independently associated with mortality at 30 days and 1 year and provide incremental value in risk stratification for mortality, with low albumin providing the largest value (hazard ratio: 1.52). Those with low albumin and slower walking speed had longer lengths of stay and higher rates of bleeding and readmission (p < 0.001). Those with anemia also had higher rates of bleeding, readmission, and subsequent myocardial infarction (p < 0.001).
This represents the largest study to date of the role of frailty indices after TAVR, further facilitating robust modeling and adjusting for a large number of confounders. These simple indices are easily attainable, and clinically relevant markers of frailty that may meaningfully stratify patients at risk for mortality after TAVR.
[Display omitted]</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>31973795</pmid><doi>10.1016/j.jcin.2019.08.015</doi><tpages>13</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1936-8798 |
| ispartof | JACC. Cardiovascular interventions, 2020-01, Vol.13 (2), p.219-231 |
| issn | 1936-8798 1876-7605 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2344276924 |
| source | Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; ScienceDirect Journals (5 years ago - present) |
| subjects | patient selection risk score TAVR |
| title | The Effect and Relationship of Frailty Indices on Survival After Transcatheter Aortic Valve Replacement |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-21T17%3A36%3A32IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=The%20Effect%20and%20Relationship%20of%20Frailty%C2%A0Indices%20on%20Survival%20After%20Transcatheter%20Aortic%C2%A0Valve%C2%A0Replacement&rft.jtitle=JACC.%20Cardiovascular%20interventions&rft.au=Kiani,%20Soroosh&rft.aucorp=STS/ACC%20TVT%20Registry&rft.date=2020-01-27&rft.volume=13&rft.issue=2&rft.spage=219&rft.epage=231&rft.pages=219-231&rft.issn=1936-8798&rft.eissn=1876-7605&rft_id=info:doi/10.1016/j.jcin.2019.08.015&rft_dat=%3Cproquest_cross%3E2344276924%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2344276924&rft_id=info:pmid/31973795&rft_els_id=S1936879819317522&rfr_iscdi=true |