Impact of frailty on health-related quality of life 1 year after transcatheter aortic valve implantation.

Autor:	Goudzwaard JA; Erasmus MC University Medical Center, Section of Geriatrics, Department of Internal Medicine, Rotterdam, The Netherlands., de Ronde-Tillmans MJAG; Erasmus MC University Medical Center, Department of Cardiology, Thoraxcenter, Rotterdam, The Netherlands., van Hoorn FED; Erasmus MC University Medical Center, Section of Geriatrics, Department of Internal Medicine, Rotterdam, The Netherlands., Kwekkeboom EHC; Erasmus MC University Medical Center, Section of Geriatrics, Department of Internal Medicine, Rotterdam, The Netherlands., Lenzen MJ; Erasmus MC University Medical Center, Department of Cardiology, Thoraxcenter, Rotterdam, The Netherlands., van Wiechen MPH; Erasmus MC University Medical Center, Department of Cardiology, Thoraxcenter, Rotterdam, The Netherlands., Ooms JFW; Erasmus MC University Medical Center, Department of Cardiology, Thoraxcenter, Rotterdam, The Netherlands., Nuis RJ; Erasmus MC University Medical Center, Department of Cardiology, Thoraxcenter, Rotterdam, The Netherlands., Van Mieghem NM; Erasmus MC University Medical Center, Department of Cardiology, Thoraxcenter, Rotterdam, The Netherlands., Daemen J; Erasmus MC University Medical Center, Department of Cardiology, Thoraxcenter, Rotterdam, The Netherlands., de Jaegere PPT; Erasmus MC University Medical Center, Department of Cardiology, Thoraxcenter, Rotterdam, The Netherlands., Mattace-Raso FUS; Erasmus MC University Medical Center, Section of Geriatrics, Department of Internal Medicine, Rotterdam, The Netherlands.
Jazyk:	angličtina
Zdroj:	Age and ageing [Age Ageing] 2020 Oct 23; Vol. 49 (6), pp. 989-994.
DOI:	10.1093/ageing/afaa071
Abstrakt:	Background: Transcatheter aortic valve implantation (TAVI) brings symptom relief and improvement in health-related quality of life (HRQoL) in the majority of patients treated for symptomatic, severe aortic stenosis. However, there is a substantial group of patients that do not benefit from TAVI. The aim of this study is to investigate the impact of frailty on HRQoL 1 year after TAVI. Methods: The TAVI Care & Cure Program is an ongoing, prospective, observational study including patients referred for TAVI to our institution. A comprehensive geriatric assessment was performed to evaluate existence of frailty using the Erasmus Frailty Score (EFS). HRQoL was assessed using the EQ-5D-5 L at baseline and 1 year after TAVI. Results: 239 patients underwent TAVI and completed HRQoL assessment 1 year after TAVI. Seventy (29.3%) patients were classified as frail (EFS ≥ 3). In non-frail patients, the EQ-5D-5 L index did not change (0.71(± 0.22) to 0.68(± 0.33) points, P = 0.22); in frail patients, the EQ-5D-5 L index decreased from 0.55(±0.26) to 0.44 points (±0.33) (P = 0.022). Frailty was an independent predictor of deteriorated HRQoL 1 year after TAVI (OR 2.24, 95% CI 1.07-4.70, P = 0.003). In frail patients, the absence of peripheral artery disease (OR 0.17, 95% 0.05-0.50, P = 0.001) and renal dysfunction (OR 0.13, 95% CI 0.04-0.41, P = <0.001) at baseline was associated with improved HRQoL 1 year after TAVI. Conclusion: Frailty is associated with deterioration of HRQoL 1 year after TAVI. Notably, HRQoL did improve in frail patients with no peripheral arterial disease or renal impairment at baseline. (© The Author(s) 2020. Published by Oxford University Press on behalf of the British Geriatrics Society.)
Databáze:	MEDLINE
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