| Autor: |
Bagur, Rodrigo, Martin, Glen Philip, Nombela-Franco, Luis, Doshi, Sagar N., George, Sudhakar, Toggweiler, Stefan, Sponga, Sandro, Cotton, James M., Khogali, Saib S., Ratib, Karim, Kinnaird, Tim, Anderson, Richard A., Chu, Michael W. A., Kiaii, Bob, Biagioni, Corina, Schofield-Kelly, Lois, Loretz, Lucca, Torracchi, Leonardo, Sekar, Baskar, Chun Shing Kwok |
| Předmět: |
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| Zdroj: |
Heart; Dec2018, Vol. 104 Issue 24, p2058-2066, 9p, 3 Charts, 4 Graphs |
| Abstrakt: |
Objectives: To investigate the association of the CharlsonComorbidity Index (CCI) with clinical outcomes after transcatheter aortic valve implantation (TAVI).Background: Patients undergoing TAVI have high comorbid burden; however, there is limited evidence of its impact on clinical outcomes.Methods: Data from 1887 patients from the UK, Canada, Spain, Switzerland and Italy were collected between 2007 and 2016. The association of CCI with 30-day mortality, Valve Academic Research Consortium-2 (VARC-2) composite early safety, long-term survival and length of stay (LoS) was calculated using logistic regression and Cox proportional hazard models, as a whole cohort and at a country level, through a two-stage individual participant data (IPD) random effect meta-analysis.Results: Most (60%) of patients had a CCI ≥3. A weak correlation was found between the total CCI and four different preoperative risks scores (ρ=0.16 to 0.29), and approximately 50% of patients classed as low risk from four risk prediction models still presented with a CCI ≥3. Per-unit increases in total CCI were not associated with increased odds of 30-day mortality (OR 1.09, 95% CI 0.96 to 1.24) or VARC-2 early safety (OR 1.04, 95% CI 0.96 to 1.14) but were associated with increased hazard of long-term mortality (HR 1.10, 95% CI 1.05 to 1.16). The two-stage IPD meta-analysis indicated that CCI was not associated with LoS (HR 0.97, 95% CI 0.93 to 1.02).Conclusion: In this multicentre international study, patients undergoing TAVI had significant comorbid burden. We found a weak correlation between the CCI and well-established preoperative risks scores. The CCI had a moderate association with long-term mortality up to 5 years post-TAVI. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
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