PMID- 27456092
OWN - NLM
STAT- MEDLINE
DCOM- 20170213
LR  - 20181202
IS  - 1477-7525 (Electronic)
IS  - 1477-7525 (Linking)
VI  - 14
IP  - 1
DP  - 2016 Jul 26
TI  - Quality of life among elderly patients undergoing transcatheter or surgical 
      aortic valve replacement- a model-based longitudinal data analysis.
PG  - 109
LID - 10.1186/s12955-016-0512-9 [doi]
LID - 109
AB  - BACKGROUND: Quality of life (QoL) measurements reported in observational studies 
      are often biased, since patients who failed to improve are more likely to be 
      unable to respond due to death or impairment. In order to observe the development 
      of QoL in patients close to death, we analyzed a set of monthly QoL measurements 
      for a cohort of elderly patients treated for aortic valve stenosis (AS) with 
      special consideration of the effect of distance to death. METHODS: QoL in 169 
      elderly patients (age >/= 75 years), treated either with transcatheter aortic valve 
      replacement (TAVR; n = 92), surgical aortic-valve replacement (n = 70), or 
      drug-based therapy (n = 7), was evaluated using the standardized EQ-5D 
      questionnaire. Over a two-year period, patients were consulted using monthly 
      telephone interviews or outpatient visits, leading to a total of 2463 time points 
      at which QoL values, New York Heart Association (NYHA) Functional Classification 
      and their status of assistance were assessed. Furthermore, post-procedural 
      clinical events and complications were monitored. Linear and ordered logistic 
      regression analyses with random intercept were carried out, taking into account 
      overall trends and distance to death. RESULTS: QoL measures decreased slightly 
      over time, were temporarily impaired at month 1 after the initial episode of 
      hospitalization and decreased substantially at the end of life with a measurable 
      effect starting at the sixth from last follow-up (month) before death. Many 
      clinical complications (bleeding complications, stroke, acute kidney injury) 
      showed an impairment of QoL measurements, but the inclusion of lagged variables 
      demonstrated medium term (three months) QoL impairments for access site bleeding 
      only. All other complications are associated with event-related impairments that 
      decreased dramatically at the second and third follow-up interviews (month) after 
      event. CONCLUSIONS: Distance to death shows clear effects on QoL and should be 
      taken into account when analyzing QoL measures in the elderly patients treated 
      for aortic valve stenosis. TRIAL REGISTRATION: German Clinical Trial Register Nr. 
      DRKS00000797.
FAU - Kaier, Klaus
AU  - Kaier K
AUID- ORCID: 0000-0003-0837-6945
AD  - Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical 
      Center - University of Freiburg, Stefan-Meier-Str. 26, D-79104, Freiburg, 
      Germany. kaier@imbi.uni-freiburg.de.
AD  - Department of Cardiology, Heart Center Freiburg University, Freiburg, Germany. 
      kaier@imbi.uni-freiburg.de.
FAU - Gutmann, Anja
AU  - Gutmann A
AD  - Department of Cardiology, Heart Center Freiburg University, Freiburg, Germany.
FAU - Baumbach, Hardy
AU  - Baumbach H
AD  - Department of Cardiovascular Surgery, Robert-Bosch-Krankenhaus, Stuttgart, 
      Germany.
FAU - von Zur Muhlen, Constantin
AU  - von Zur Muhlen C
AD  - Department of Cardiology, Heart Center Freiburg University, Freiburg, Germany.
FAU - Hehn, Philip
AU  - Hehn P
AD  - Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical 
      Center - University of Freiburg, Stefan-Meier-Str. 26, D-79104, Freiburg, 
      Germany.
FAU - Vach, Werner
AU  - Vach W
AD  - Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical 
      Center - University of Freiburg, Stefan-Meier-Str. 26, D-79104, Freiburg, 
      Germany.
FAU - Beyersdorf, Friedhelm
AU  - Beyersdorf F
AD  - Department of Cardiovascular Surgery, Heart Center Freiburg University, Freiburg, 
      Germany.
FAU - Zehender, Manfred
AU  - Zehender M
AD  - Department of Cardiology, Heart Center Freiburg University, Freiburg, Germany.
FAU - Bode, Christoph
AU  - Bode C
AD  - Department of Cardiology, Heart Center Freiburg University, Freiburg, Germany.
FAU - Reinohl, Jochen
AU  - Reinohl J
AD  - Department of Cardiology, Heart Center Freiburg University, Freiburg, Germany.
LA  - eng
PT  - Journal Article
DEP - 20160726
PL  - England
TA  - Health Qual Life Outcomes
JT  - Health and quality of life outcomes
JID - 101153626
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Aortic Valve Stenosis/*surgery
MH  - Female
MH  - Heart Valve Prosthesis/*psychology
MH  - Heart Valve Prosthesis Implantation/*psychology
MH  - Humans
MH  - Male
MH  - Patients/psychology
MH  - Quality of Life/*psychology
MH  - Risk Factors
MH  - Surveys and Questionnaires
MH  - Treatment Outcome
PMC - PMC4960709
OTO - NOTNLM
OT  - AVR
OT  - Aortic valve replacement
OT  - EQ-5D
OT  - Quality of life
OT  - TAVI
OT  - TAVR
OT  - Transcatheter aortic valve implantation
OT  - Transcatheter aortic valve replacement
EDAT- 2016/07/28 06:00
MHDA- 2017/02/14 06:00
PMCR- 2016/07/26
CRDT- 2016/07/27 06:00
PHST- 2016/01/06 00:00 [received]
PHST- 2016/07/17 00:00 [accepted]
PHST- 2016/07/27 06:00 [entrez]
PHST- 2016/07/28 06:00 [pubmed]
PHST- 2017/02/14 06:00 [medline]
PHST- 2016/07/26 00:00 [pmc-release]
AID - 10.1186/s12955-016-0512-9 [pii]
AID - 512 [pii]
AID - 10.1186/s12955-016-0512-9 [doi]
PST - epublish
SO  - Health Qual Life Outcomes. 2016 Jul 26;14(1):109. doi: 10.1186/s12955-016-0512-9.