PMID- 32461504
OWN - NLM
STAT- MEDLINE
DCOM- 20201207
LR  - 20201214
IS  - 1347-4820 (Electronic)
IS  - 1346-9843 (Linking)
VI  - 84
IP  - 7
DP  - 2020 Jun 25
TI  - Hospital-Acquired Functional Decline and Clinical Outcomes in Older Patients 
      Undergoing Transcatheter Aortic Valve Implantation.
PG  - 1083-1089
LID - 10.1253/circj.CJ-19-1037 [doi]
AB  - BACKGROUND: This study aimed to assess the relationship between hospital-acquired 
      functional decline and the risk of mid-term all-cause death in older patients 
      undergoing transcatheter aortic valve implantation (TAVI).Methods and Results:In 
      total, 463 patients (mean age 85 years, interquartile range [IQR]: 82, 88) 
      undergoing elective TAVI at Sakakibara Heart Institute between 2010 and 2018, who 
      were followed up for 3 years, were enrolled in the study. Hospital-acquired 
      functional decline after TAVI, which was defined by at least a 1-point decrease 
      on the Short Physical Performance Battery before discharge compared to the 
      preoperative score, was assessed. A total of 113 patients (24.4%) showed 
      hospital-acquired functional decline after TAVI, and 50 (11.3%) patients died 
      over a mean follow-up period of 1.9+/-0.8 years. Kaplan-Meier survival curves 
      indicated that hospital-acquired functional decline was significantly associated 
      with all-cause mortality (log-rank test, P=0.001). On multivariate Cox regression 
      analysis, hospital-acquired functional decline was associated with a higher risk 
      of all-cause mortality (OR 2.108, 95% CI 1.119-3.968, P=0.021) independent of 
      sex, body mass index, advanced chronic kidney disease, and preoperative frailty, 
      as assessed by the modified essential frail toolkit. CONCLUSIONS: 
      Hospital-acquired functional decline is associated with mid-term all-cause 
      mortality in older patients following TAVI. Trajectory of functional status is a 
      vital sign, and it is useful for risk stratification in older patients following 
      TAVI.
FAU - Saitoh, Masakazu
AU  - Saitoh M
AD  - Department of Rehabilitation, Sakakibara Heart Institute.
FAU - Saji, Mike
AU  - Saji M
AD  - Department of Cardiology, Sakakibara Heart Institute.
FAU - Kozono-Ikeya, Aika
AU  - Kozono-Ikeya A
AD  - Department of Rehabilitation, Sakakibara Heart Institute.
FAU - Arimitsu, Takeshi
AU  - Arimitsu T
AD  - Department of Rehabilitation, Sakakibara Heart Institute.
FAU - Sakuyama, Akihiro
AU  - Sakuyama A
AD  - Department of Rehabilitation, Sakakibara Heart Institute.
FAU - Ueki, Hiromichi
AU  - Ueki H
AD  - Department of Rehabilitation, Sakakibara Heart Institute.
FAU - Nagayama, Masatoshi
AU  - Nagayama M
AD  - Department of Cardiology, Sakakibara Heart Institute.
FAU - Isobe, Mitsuaki
AU  - Isobe M
AD  - Department of Cardiology, Sakakibara Heart Institute.
LA  - eng
PT  - Journal Article
DEP - 20200526
PL  - Japan
TA  - Circ J
JT  - Circulation journal : official journal of the Japanese Circulation Society
JID - 101137683
SB  - IM
CIN - Circ J. 2020 Jun 25;84(7):1055-1056. PMID: 32507796
MH  - Age Factors
MH  - Aged, 80 and over
MH  - Aortic Valve Stenosis/diagnostic imaging/mortality/*surgery
MH  - Female
MH  - *Functional Status
MH  - *Geriatric Assessment
MH  - Heart Disease Risk Factors
MH  - Humans
MH  - Male
MH  - Predictive Value of Tests
MH  - Retrospective Studies
MH  - Risk Assessment
MH  - Time Factors
MH  - Transcatheter Aortic Valve Replacement/*adverse effects/mortality
MH  - Treatment Outcome
OTO - NOTNLM
OT  - All-cause death
OT  - Frailty
OT  - Hospital-acquired functional decline
OT  - Mid-term outcome
OT  - Transcatheter aortic valve implantation
EDAT- 2020/05/29 06:00
MHDA- 2020/12/15 06:00
CRDT- 2020/05/29 06:00
PHST- 2020/05/29 06:00 [pubmed]
PHST- 2020/12/15 06:00 [medline]
PHST- 2020/05/29 06:00 [entrez]
AID - 10.1253/circj.CJ-19-1037 [doi]
PST - ppublish
SO  - Circ J. 2020 Jun 25;84(7):1083-1089. doi: 10.1253/circj.CJ-19-1037. Epub 2020 May 
      26.