Fitness-Tracker Assisted Frailty-Assessment Before Transcatheter Aortic Valve Implantation: Proof-of-Concept Study
| Autor: | Georg Delle Karth, Gabriel Weiss, Andreas Strouhal, Victoria Watzal, Martin Grabenwöger, Christopher Adlbrecht, Bernhard Winkler, Martin Andreas, Markus Mach, Waseem Hasan |
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| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Transcatheter aortic medicine.medical_treatment Health Informatics Information technology 030204 cardiovascular system & hematology Risk Assessment Transcatheter Aortic Valve Replacement 03 medical and health sciences 0302 clinical medicine Valve replacement Risk Factors Internal medicine Heart rate medicine Humans Prospective Studies Prospective cohort study transcatheter aortic valve implantation Aged Original Paper Frailty business.industry activity Area under the curve EuroSCORE 030229 sport sciences medicine.disease T58.5-58.64 Frailty assessment fitness Treatment Outcome Aortic valve stenosis Cardiology transcatheter aortic valve repair Public aspects of medicine RA1-1270 business tracker |
| Zdroj: | JMIR mHealth and uHealth JMIR mHealth and uHealth, Vol 8, Iss 10, p e19227 (2020) |
| ISSN: | 2291-5222 |
| Popis: | Background While transcatheter aortic valve replacement (TAVR) has revolutionized the treatment of aortic valve stenosis, wearable health-monitoring devices are gradually transforming digital patient care. Objective The aim of this study was to develop a simple, efficient, and economical method for preprocedural frailty assessment based on parameters measured by a wearable health-monitoring device. Methods In this prospective study, we analyzed data of 50 consecutive patients with mean (SD) age of 77.5 (5.1) years and a median (IQR) European system for cardiac operative risk evaluation (EuroSCORE) II of 3.3 (4.1) undergoing either transfemoral or transapical TAVR between 2017 and 2018. Every patient was fitted with a wrist-worn health-monitoring device (Garmin Vivosmart 3) for 1 week prior to the procedure. Twenty different parameters were measured, and threshold levels for the 3 most predictive categories (ie, step count, heart rate, and preprocedural stress) were calculated. Patients were assigned 1 point per category for exceeding the cut-off value and were then classified into 4 stages (no, borderline, moderate, and severe frailty). Furthermore, the FItness-tracker assisted Frailty-Assessment Score (FIFA score) was compared with the scores of the preprocedural gait speed category derived from the 6-minute walk test (GSC-6MWT) and the Edmonton Frail Scale classification (EFS-C). The primary study endpoint was hospital mortality. Results The overall preprocedural stress level (P=.02), minutes of high stress per day (P=.02), minutes of rest per day (P=.045), and daily heart rate maximum (P=.048) as single parameters were the strongest predictors of hospital mortality. When comparing the different frailty scores, the FIFA score demonstrated the greatest predictive power for hospital mortality (FIFA area under the curve [AUC] 0.844, CI 0.656-1.000; P=.048; GSC-6MWT AUC 0.671, CI 0.487-0.855; P=.42; EFS-C AUC 0.636, CI 0.254-1.000; P=.44). Conclusions This proof-of-concept study demonstrates the strong predictive performance of the FIFA score compared to that of the conventional frailty assessments. |
| Databáze: | OpenAIRE |
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