Decision making in treatment of symptomatic severe aortic stenosis: a survey study in Dutch heart centres.

Autor: van Beek-Peeters JJAM; Department of Cardiothoracic Surgery, Amphia Hospital, Breda, The Netherlands. jvanbeek1@amphia.nl., van den Ende Z; Department of Geriatrics, Amphia Hospital, Breda, The Netherlands., Faes MC; Department of Geriatrics, Amphia Hospital, Breda, The Netherlands., de Vos AJBM; Amphia Academy, Amphia Hospital, Breda, The Netherlands., van Geldorp MWA; Department of Cardiothoracic Surgery, Amphia Hospital, Breda, The Netherlands., Van den Branden BJL; Department of Interventional Cardiology, Amphia Hospital, Breda, The Netherlands., van der Meer BJM; TIAS School for Business and Society, Tilburg University, Tilburg, The Netherlands.; Board of Directors, Catharina Hospital, Eindhoven, The Netherlands., Minkman MMN; TIAS School for Business and Society, Tilburg University, Tilburg, The Netherlands.; Vilans, Centre of Expertise for Long-term Care, Utrecht, The Netherlands.
Jazyk: angličtina
Zdroj: Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation [Neth Heart J] 2022 Sep; Vol. 30 (9), pp. 423-428. Date of Electronic Publication: 2022 Apr 05.
DOI: 10.1007/s12471-022-01676-w
Abstrakt: Aim: To provide insight into the basic characteristics of decision making in the treatment of symptomatic severe aortic stenosis (SSAS) in Dutch heart centres with specific emphasis on the evaluation of frailty, cognition, nutritional status and physical functioning/functionality in (instrumental) activities of daily living [(I)ADL].
Methods: A questionnaire was used that is based on the European and American guidelines for SSAS treatment. The survey was administered to physicians and non-physicians in Dutch heart centres involved in the decision-making pathway for SSAS treatment.
Results: All 16 Dutch heart centres participated. Before a patient case is discussed by the heart team, heart centres rarely request data from the referring hospital regarding patients' functionality (n = 5), frailty scores (n = 0) and geriatric consultation (n = 1) as a standard procedure. Most heart centres 'often to always' do their own screening for frailty (n = 10), cognition/mood (n = 9), nutritional status (n = 10) and physical functioning/functionality in (I)ADL (n = 10). During heart team meetings data are 'sometimes to regularly' available regarding frailty (n = 5), cognition/mood (n = 11), nutritional status (n = 8) and physical functioning/functionality in (I)ADL (n = 10). After assessment in the outpatient clinic patient cases are re-discussed 'sometimes to regularly' in heart team meetings (n = 10).
Conclusions: Dutch heart centres make an effort to evaluate frailty, cognition, nutritional status and physical functioning/functionality in (I)ADL for decision making regarding SSAS treatment. However, these patient data are not routinely requested from the referring hospital and are not always available for heart team meetings. Incorporation of these important data in a structured manner early in the decision-making process may provide additional useful information for decision making in the heart team meeting.
(© 2022. The Author(s).)
Databáze: MEDLINE
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