Association between frailty and self-reported health following heart valve surgery.

Autor:	Borregaard B; Department of Cardiology, Odense University Hospital, Denmark.; Department of Cardiothoracic and Vascular Surgery, Odense University Hospital, Denmark.; University of Southern Denmark, Denmark., Dahl JS; Department of Cardiology, Odense University Hospital, Denmark.; University of Southern Denmark, Denmark., Lauck SB; Centre for Heart Valve Innovation, St. Paul's Hospital, Canada.; University of British Columbia, Canada., Ryg J; University of Southern Denmark, Denmark.; Department of Geriatric Medicine, Odense University Hospital, Denmark., Berg SK; Department of Clinical Medicine, University of Copenhagen, Denmark.; The Heart Centre, Rigshospitalet, Copenhagen University Hospital, Denmark., Ekholm O; University of Southern Denmark, Denmark., Hendriks JM; Centre for Heart Rhythm Disorders, South Australian Health and Medical Research Institute, Royal Adelaide Hospital, Australia.; College of Nursing and Health Sciences, Flinders University, Australia.; Department of Health, Medicine and Caring Sciences, Linköping University, Sweden., Riber LPS; Department of Cardiothoracic and Vascular Surgery, Odense University Hospital, Denmark.; University of Southern Denmark, Denmark., Norekvål TM; Department of Heart Disease, Haukeland University Hospital, Norway.; Department of Clinical Science, University of Bergen, Norway.; Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Norway., Møller JE; Department of Cardiology, Odense University Hospital, Denmark.; University of Southern Denmark, Denmark.; The Heart Centre, Rigshospitalet, Copenhagen University Hospital, Denmark.
Jazyk:	angličtina
Zdroj:	International journal of cardiology. Heart & vasculature [Int J Cardiol Heart Vasc] 2020 Nov 13; Vol. 31, pp. 100671. Date of Electronic Publication: 2020 Nov 13 (Print Publication: 2020).
DOI:	10.1016/j.ijcha.2020.100671
Abstrakt:	Background: Knowledge about the association between frailty and self-reported health among patients undergoing heart valve surgery remains sparse. Thus, the objectives were to I) describe changes in self-reported health at different time points according to frailty status, and to II) investigate the association between frailty status at discharge and poor self-reported health four weeks after discharge among patients undergoing heart valve surgery. Methods: In a prospective cohort study, consecutive patients undergoing heart valve surgery, including transapical/transaortic valve procedures were included. Frailty was measured using the Fried score, and self-reported health using the Kansas City Cardiomyopathy Questionnaire (KCCQ) and the EuroQoL-5 Dimensions 5-Levels Health Status Questionnaire (EQ-5D-5L).To investigate the association between frailty and self-reported health, multivariable logistic regression models were used. Analyses were adjusted for sex, age, surgical risk evaluation (EuroScore) and procedure and presented as odds ratios (OR) with 95% confidence intervals (CI). Results: Frailty was assessed at discharge in 288 patients (median age 71, 69% men); 51 patients (18%) were frail. In the multivariable analyses, frailty at discharge remained significantly associated with poor self-reported health at four weeks, OR (95% CI): EQ-5D-5L Index 3.38 (1.51-7.52), VAS 2.41 (1.13-5.14), and KCCQ 2.84 (1.35-5.97). Conclusion: Frailty is present at discharge in 18% of patients undergoing heart valve surgery, and being frail is associated with poor self-reported health at four weeks of follow-up. This supports a clinical need to address the unique risk of frail patients among heart valve teams broadly, and not only to measure frailty as a marker of operative risk. Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. (© 2020 The Authors.)
Databáze:	MEDLINE
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