PMID- 26119601
OWN - NLM
STAT- MEDLINE
DCOM- 20160906
LR  - 20220330
IS  - 1522-726X (Electronic)
IS  - 1522-1946 (Linking)
VI  - 86
IP  - 7
DP  - 2015 Dec 1
TI  - Poor mobility predicts adverse outcome better than other frailty indices in 
      patients undergoing transcatheter aortic valve implantation.
PG  - 1271-7
LID - 10.1002/ccd.25991 [doi]
AB  - BACKGROUND: Surgical risk scoring systems are poor at predicting outcome in 
      patients undergoing transcatheter aortic valve implantation (TAVI). Frailty 
      indices might more accurately predict outcome. AIMS: To examine multiple frailty 
      indices as markers of performance to see whether they predict outcomes both in 
      the shorter (30 days) and longer terms (5 years) in patients who have undergone 
      TAVI. METHODS: Frailty indices (Mobility; Brighton Mobility Index, New York Heart 
      Association (NYHA), Karnofsky Performance Index, Canadian Study Health 
      Association (CSHA) clinical frailty scale, and Katz Index of Dependence) were 
      assessed in 312 consecutive TAVI patients. Mortality tracking was obtained from 
      the Office of National Statistics as of May 2014. RESULTS: Mean age was 
      81.2 +/- 7.0 years; 53.2% were male. Mean Logistic EuroSCORE and STS were 
      17.4 +/- 9.4 and 4.6 +/- 2.8, respectively. Mean peak aortic valve gradient and 
      aortic valve area were 79.1 +/- 28.0 mm Hg and 0.72 +/- 0.25 cm(2) , respectively. 
      30-day mortality was 4.8%; long-term mortality (maximum 5.8 years, mean 2.2 +/- 1.5 
      years) was 25.3%. Both univariate and multivariate analyses confirmed poor 
      mobility (defined as severe impairment of mobility secondary to musculoskeletal 
      or neurological dysfunction (Euroscore II risk)), as the best predictor of 
      adverse outcome over both the short-term (OR 4.03, 95% CI (1.36-11.96), P = 0.012 
      (30 days)) and longer term (OR 2.15, 95% CI (1.33-3.48), P = 0.002, (2.2 +/- 1.5 
      years.)). CONCLUSION: Poor mobility predicts worse survival among patients 
      undergoing TAVI, both in the shorter and longer terms. Our data suggest that 
      mobility impairment, of either neurological or musculoskeletal etiology, is an 
      appropriate screening measure when considering patients for TAVI.
CI  - (c) 2015 Wiley Periodicals, Inc.
FAU - Cockburn, James
AU  - Cockburn J
AD  - Sussex Cardiac Centre, Brighton and Sussex University Hospitals NHS Trust, 
      Brighton, United Kingdom.
FAU - Singh, Meera Sundar
AU  - Singh MS
AD  - Sussex Cardiac Centre, Brighton and Sussex University Hospitals NHS Trust, 
      Brighton, United Kingdom.
FAU - Rafi, Nur Hanis Mohammed
AU  - Rafi NH
AD  - Sussex Cardiac Centre, Brighton and Sussex University Hospitals NHS Trust, 
      Brighton, United Kingdom.
FAU - Dooley, Maureen
AU  - Dooley M
AD  - Sussex Cardiac Centre, Brighton and Sussex University Hospitals NHS Trust, 
      Brighton, United Kingdom.
FAU - Hutchinson, Nevil
AU  - Hutchinson N
AD  - Sussex Cardiac Centre, Brighton and Sussex University Hospitals NHS Trust, 
      Brighton, United Kingdom.
FAU - Hill, Andrew
AU  - Hill A
AD  - Sussex Cardiac Centre, Brighton and Sussex University Hospitals NHS Trust, 
      Brighton, United Kingdom.
FAU - Trivedi, Uday
AU  - Trivedi U
AD  - Sussex Cardiac Centre, Brighton and Sussex University Hospitals NHS Trust, 
      Brighton, United Kingdom.
FAU - de Belder, Adam
AU  - de Belder A
AD  - Sussex Cardiac Centre, Brighton and Sussex University Hospitals NHS Trust, 
      Brighton, United Kingdom.
FAU - Hildick-Smith, David
AU  - Hildick-Smith D
AD  - Sussex Cardiac Centre, Brighton and Sussex University Hospitals NHS Trust, 
      Brighton, United Kingdom.
LA  - eng
PT  - Journal Article
DEP - 20150629
PL  - United States
TA  - Catheter Cardiovasc Interv
JT  - Catheterization and cardiovascular interventions : official journal of the 
      Society for Cardiac Angiography & Interventions
JID - 100884139
SB  - IM
CIN - Catheter Cardiovasc Interv. 2015 Dec 1;86(7):1278-9. PMID: 26582325
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Aortic Valve/physiopathology
MH  - Aortic Valve Stenosis/diagnosis/mortality/physiopathology/*therapy
MH  - Cardiac Catheterization/*adverse effects/mortality
MH  - Databases, Factual
MH  - England
MH  - Female
MH  - *Frail Elderly
MH  - Geriatric Assessment
MH  - Heart Valve Prosthesis Implantation/*adverse effects/mortality
MH  - Humans
MH  - Kaplan-Meier Estimate
MH  - Karnofsky Performance Status
MH  - Logistic Models
MH  - Male
MH  - Middle Aged
MH  - *Mobility Limitation
MH  - Odds Ratio
MH  - Proportional Hazards Models
MH  - Risk Adjustment
MH  - Risk Factors
MH  - Time Factors
MH  - Treatment Outcome
OTO - NOTNLM
OT  - TAVI
OT  - aortic disease
OT  - aortic valve disease
OT  - outcome predictors
EDAT- 2015/06/30 06:00
MHDA- 2016/09/07 06:00
CRDT- 2015/06/30 06:00
PHST- 2014/10/23 00:00 [received]
PHST- 2015/04/04 00:00 [accepted]
PHST- 2015/06/30 06:00 [entrez]
PHST- 2015/06/30 06:00 [pubmed]
PHST- 2016/09/07 06:00 [medline]
AID - 10.1002/ccd.25991 [doi]
PST - ppublish
SO  - Catheter Cardiovasc Interv. 2015 Dec 1;86(7):1271-7. doi: 10.1002/ccd.25991. Epub 
      2015 Jun 29.