PMID- 32193850 OWN - NLM STAT- MEDLINE DCOM- 20210302 LR - 20210730 IS - 1720-8319 (Electronic) IS - 1594-0667 (Print) IS - 1594-0667 (Linking) VI - 33 IP - 2 DP - 2021 Feb TI - Baseline frailty status and outcomes important for shared decision-making in older adults receiving transcatheter aortic valve implantation, a prospective observational study. PG - 345-352 LID - 10.1007/s40520-020-01525-z [doi] AB - AIMS: The objective of this study was to examine baseline frailty status (including cognitive deficits) and important clinical outcomes, to inform shared decision-making in older adults receiving transcatheter aortic valve implantation (TAVI). METHODS AND RESULTS: We conducted a prospective, observational study of 82 TAVI patients, recruited 2013 to 2015, with 2-year follow-up. Mean age was 83 years (standard deviation (SD) 4.7). Eighteen percent of the patients were frail, as assessed with an 8-item frailty scale. Fifteen patients (18%) had a Mini-Mental Status Examination (MMSE) score below 24 points at baseline, indicating cognitive impairment or dementia and five patients had an MMSE below 20 points. Mean New York Heart Association (NYHA) class at baseline and 6 months was 2.5 (SD 0.6) and 1.4 (SD 0.6), (p < 0.001). There was no change in mean Nottingham Extended Activities of Daily Living (NEADL) scale between baseline and 6 months, 54.2 (SD 11.5) and 54.5 (SD 10.3) points, respectively, mean difference 0.3 (p = 0.7). At 2 years, six patients (7%) had died, four (5%, n = 79) lived in a nursing home, four (5%) suffered from disabling stroke, and six (7%) contracted infective endocarditis. CONCLUSIONS: TAVI patients had improvement in symptoms and maintenance of activity of daily living at 6 months. They had low mortality and most patients lived in their own home 2 years after TAVI. Complications like death, stroke, and endocarditis occurred. Some patients had cognitive impairment before the procedure which might influence decision-making. Our findings may be used to develop pre-TAVI decision aids. FAU - Skaar, Elisabeth AU - Skaar E AUID- ORCID: 0000-0002-7911-884X AD - Department of Heart Disease, Haukeland University Hospital, Postboks 1400, 5021, Bergen, Norway. Elisabeth.skaar@helse-bergen.no. AD - Department of Clinical Science, University of Bergen, Bergen, Norway. Elisabeth.skaar@helse-bergen.no. FAU - Oksnes, Anja AU - Oksnes A AD - Department of Heart Disease, Haukeland University Hospital, Postboks 1400, 5021, Bergen, Norway. FAU - Eide, Leslie Sofia Pareja AU - Eide LSP AD - Institute of Health and Social Science, Western Norway University of Applied Sciences, Bergen, Norway. FAU - Norekval, Tone Merete AU - Norekval TM AD - Department of Heart Disease, Haukeland University Hospital, Postboks 1400, 5021, Bergen, Norway. AD - Department of Clinical Science, University of Bergen, Bergen, Norway. FAU - Ranhoff, Anette Hylen AU - Ranhoff AH AD - Department of Clinical Science, University of Bergen, Bergen, Norway. FAU - Nordrehaug, Jan Erik AU - Nordrehaug JE AD - Department of Clinical Science, University of Bergen, Bergen, Norway. FAU - Forman, Daniel Edward AU - Forman DE AD - Section of Geriatric Cardiology, University of Pittsburgh, Medical Center, and Geriatric Research, Education, and Clinical Center, VA Pittsburgh Healthcare System, Pittsburgh, USA. FAU - Schoenenberger, Andreas W AU - Schoenenberger AW AD - Department of Geriatrics, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland. FAU - Hufthammer, Karl Ove AU - Hufthammer KO AD - Centre for Clinical Research, Haukeland University Hospital, Bergen, Norway. FAU - Kuiper, Karel Kier-Jan AU - Kuiper KK AD - Department of Heart Disease, Haukeland University Hospital, Postboks 1400, 5021, Bergen, Norway. FAU - Bleie, Oyvind AU - Bleie O AD - Department of Heart Disease, Haukeland University Hospital, Postboks 1400, 5021, Bergen, Norway. FAU - Packer, Erik Jerome Stene AU - Packer EJS AD - Department of Heart Disease, Haukeland University Hospital, Postboks 1400, 5021, Bergen, Norway. AD - Department of Clinical Science, University of Bergen, Bergen, Norway. FAU - Langorgen, Jorund AU - Langorgen J AD - Department of Heart Disease, Haukeland University Hospital, Postboks 1400, 5021, Bergen, Norway. FAU - Haaverstad, Rune AU - Haaverstad R AD - Department of Heart Disease, Haukeland University Hospital, Postboks 1400, 5021, Bergen, Norway. AD - Department of Clinical Science, University of Bergen, Bergen, Norway. FAU - Schaufel, Margrethe Aase AU - Schaufel MA AD - Department of Thoracic Medicine, Haukeland University Hospital, Bergen, Norway. LA - eng PT - Journal Article PT - Observational Study DEP - 20200319 PL - Germany TA - Aging Clin Exp Res JT - Aging clinical and experimental research JID - 101132995 SB - IM MH - Activities of Daily Living MH - Aged MH - Aged, 80 and over MH - Aortic Valve/surgery MH - *Aortic Valve Stenosis/surgery MH - *Frailty MH - Humans MH - Prospective Studies MH - Risk Factors MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - Treatment Outcome PMC - PMC7914240 OTO - NOTNLM OT - Activity of daily living OT - Aortic stenosis OT - Older adults OT - Shared decision making OT - TAVI COIS- On behalf of all authors, the corresponding author states that there is no conflict of interest. EDAT- 2020/03/21 06:00 MHDA- 2021/03/03 06:00 PMCR- 2020/03/19 CRDT- 2020/03/21 06:00 PHST- 2019/12/12 00:00 [received] PHST- 2020/02/26 00:00 [accepted] PHST- 2020/03/21 06:00 [pubmed] PHST- 2021/03/03 06:00 [medline] PHST- 2020/03/21 06:00 [entrez] PHST- 2020/03/19 00:00 [pmc-release] AID - 10.1007/s40520-020-01525-z [pii] AID - 1525 [pii] AID - 10.1007/s40520-020-01525-z [doi] PST - ppublish SO - Aging Clin Exp Res. 2021 Feb;33(2):345-352. doi: 10.1007/s40520-020-01525-z. Epub 2020 Mar 19.