Evaluation of Multidimensional Geriatric Assessment as a Predictor of Mortality and Cardiovascular Events After Transcatheter Aortic Valve Implantation
Open accessAbstract
Objectives This study evaluated Multidimensional Geriatric Assessment (MGA) as predictor of mortality and major adverse cardiovascular and cerebral events (MACCE) after transcatheter aortic valve implantation (TAVI).Background Currently used global risk scores do not reliably estimate mortality and MACCE in these patients.Methods This prospective cohort comprised 100 consecutive patients ≥ 70 years undergoing TAVI. Global risk scores (Society of Thoracic Surgeons [STS] score, EuroSCORE) and MGA-based scores (cognition, nutrition, mobility, activities of daily living [ADL], and frailty index) were evaluated as predictors of all-cause mortality and MACCE 30 days and 1 year after TAVI in regression models.Results In univariable analyses, all predictors were significantly associated with mortality and MACCE at 30 days and 1 year, except for the EuroSCORE at 30 days and instrumental ADL at 30 days and 1 year. Associations of cognitive impairment (odds ratio [OR]: 2.98, 95% confidence interval [CI]: 1.07 to 8.31), malnutrition (OR: 6.72, 95% CI: 2.04 to 22.17), mobility impairment (OR: 6.65, 95% CI: 2.15 to 20.52), limitations in basic ADL (OR: 3.63, 95% CI: 1.29 to 10.23), and frailty index (OR: 3.68, 95% CI: 1.21 to 11.19) with 1-year mortality were similar compared with STS score (OR: 5.47, 95% CI: 1.48 to 20.22) and EuroSCORE (OR: 4.02, 95% CI: 0.86 to 18.70). Similar results were found for 30-day mortality and MACCE. Bivariable analyses, including STS score or EuroSCORE suggested independent associations of MGA-based scores (e.g., OR of frailty index: 3.29, 95% CI: 1.06 to 10.15, for 1-year mortality in a model including EuroSCORE).Conclusions This study provides evidence that risk prediction can be improved by adding MGA-based information to global risk scores. Larger studies are needed for the development and validation of improved risk prediction models.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
When poor health status is principally due to comorbidities and geriatric conditions, valve replacement might lead to unsatisfactory results in decreased survival and decline or lack of improvement in quality of life.
“When poor health status is principally due to comorbidities and geriatric conditions, valve replacement might lead to an unsatisfactory result both in terms decreased survival and a decline or lack of improvement in quality of life253–256.”
From Calcific aortic stenosis (2016) · cites this paper as [256]
The Results section reports that several geriatric-assessment measures were associated with mortality after transcatheter aortic valve implantation, supporting the decreased-survival concern. The study did not assess quality of life or establish that poor health was principally due to comorbidities and geriatric conditions, so those parts of the claim are not supported by this paper. (LLM, conf=0.88)
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Folstein, M. F., Folstein, S. E., & McHugh, P. R. (1975) · Journal of Psychiatric Research · doi:10.1016/0022-3956(75)90026-6 · Cited by 88,282 · see citing works
Frailty in Older Adults: Evidence for a Phenotype
Fried, L. P., Tangen, C. M., Walston, J., Newman, A. B., Hirsch, C., Gottdiener, J., Seeman, T., Tracy, R., Kop, W. J., Burke, G., et al. (2001) · The Journals of Gerontology Series A: Biological Sciences and Medical Sciences · doi:10.1093/gerona/56.3.m146 · Cited by 24,907 · see citing works
The Timed “Up & Go”: A Test of Basic Functional Mobility for Frail Elderly Persons
Podsiadlo, D., & Richardson, S. (1991) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.1991.tb01616.x · Cited by 14,418 · see citing works
Transcatheter Aortic-Valve Implantation for Aortic Stenosis in Patients Who Cannot Undergo Surgery
Leon, M. B., Smith, C. R., Mack, M., Miller, D. C., Moses, J. W., Svensson, L. G., Tuzcu, E. M., Webb, J. G., Fontana, G. P., Makkar, R. R., et al. (2010) · New England Journal of Medicine · doi:10.1056/nejmoa1008232 · Cited by 7,205 · see citing works
Relaxing the Rule of Ten Events per Variable in Logistic and Cox Regression
Vittinghoff, E., & McCulloch, C. E. (2007) · American Journal of Epidemiology · doi:10.1093/aje/kwk052 · Cited by 4,359 · see citing works
Iung, B. (2003) · European Heart Journal · doi:10.1016/s0195-668x(03)00201-x · Cited by 3,530 · see citing works
Kappetein, A. P., Head, S. J., Généreux, P., Piazza, N., Mieghem, N. M. V., Blackstone, E., Brott, T., Cohen, D., Cutlip, D. E., van Es, G., et al. (2012) · doi:10.48350/15011 · Cited by 3,375 · see citing works
Self-citationKatz, S. (1963) · JAMA · doi:10.1001/jama.1963.03060120024016 · Cited by 2,421 · see citing works
Frailty as a predictor of surgical outcomes in older patients
Makary, M. A., Segev, D. L., Pronovost, P. J., Syin, D., Bandeen-Roche, K., Patel, P., Takenaga, R., Devgan, L., Holzmueller, C. G., Tian, J., et al. (2010) · Journal of the American College of Surgeons · doi:10.1016/j.jamcollsurg.2010.01.028 · Cited by 2,184 · see citing works
Leon, M. B., Piazza, N., Nikolsky, E., Blackstone, E. H., Cutlip, D. E., Kappetein, A. P., Krucoff, M. W., Mack, M. J., Mehran, R., Miller, D. C., et al. (2011) · European Heart Journal · doi:10.1093/eurheartj/ehq406 · Cited by 1,218 · see citing works
Self-citationFried, L. P. (2001) · Journals of Gerontology Series A-biological Sciences and Medical Sciences · Cited by 1,103 · see citing works
Ellis, G., Whitehead, M. A., Robinson, D., O'Neill, D., & Langhorne, P. (2011) · BMJ · doi:10.1136/bmj.d6553 · Cited by 1,068 · see citing works
Identifying the elderly at risk for malnutrition
Guigoz, Y., Lauque, S., & Vellas, B. J. (2002) · Clinics in Geriatric Medicine · doi:10.1016/s0749-0690(02)00059-9 · Cited by 983 · see citing works
Afilalo, J., Eisenberg, M. J., Morin, J.-F., Bergman, H., Monette, J., Noiseux, N., Perrault, L. P., Alexander, K. P., Langlois, Y., Dendukuri, N., et al. (2010) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2010.06.039 · Cited by 746 · see citing works
Standardized Endpoint Definitions for Transcatheter Aortic Valve Implantation Clinical Trials
Leon, M. B., Piazza, N., Nikolsky, E., Blackstone, E. H., Cutlip, D. E., Kappetein, A. P., Krucoff, M. W., Mack, M. J., Mehran, R., Miller, D. C., et al. (2011) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2010.12.005 · Cited by 731 · see citing works
Self-citationLee, D. H., Buth, K. J., Martin, B., Yip, A. M., & Hirsch, G. M. (2010) · Circulation · doi:10.1161/circulationaha.108.841437 · Cited by 677 · see citing works
Walter, L. C. (2001) · JAMA · doi:10.1001/jama.285.23.2987 · Cited by 670 · see citing works
Alexander, K. P., Anstrom, K. J., Muhlbaier, L. H., et al. (2000) · Journal of the American College of Cardiology · doi:10.1016/s0735-1097(99)00606-3 · Cited by 575 · see citing works
Transfemoral Aortic Valve Implantation
Hayashida, K., Lefèvre, T., Chevalier, B., Hovasse, T., Romano, M., Garot, P., Mylotte, D., Uribe, J., Farge, A., Donzeau‐Gouge, P., et al. (2011) · JACC: Cardiovascular Interventions · doi:10.1016/j.jcin.2011.03.019 · Cited by 566 · see citing works
Pilotto, A., Ferrucci, L., Franceschi, M., D'Ambrosio, L. P., Scarcelli, C., Cascavilla, L., Paris, F., Placentino, G., Seripa, D., Dallapiccola, B., et al. (2008) · Rejuvenation Research · doi:10.1089/rej.2007.0569 · Cited by 505 · see citing works
Rostoft, S., Nesbakken, A., Slaaen, M., Skovlund, E., Audisio, R. A., Johannessen, H., Bakka, A. O., & Wyller, T. B. (2009) · Critical Reviews in Oncology/Hematology · doi:10.1016/j.critrevonc.2009.11.002 · Cited by 456 · see citing works
Risk stratification in heart surgery: comparison of six score systems
Geissler, H. J. (2000) · European Journal of Cardio-Thoracic Surgery · doi:10.1016/s1010-7940(00)00385-7 · Cited by 334 · see citing works
Vahanian, A. S., Alfieri, O., Al‐Attar, N., Antunes, M. J., Bax, J. J., Cormier, B., Cribier, A. G., de Jaegere, P. P. T., Fournial, G., Kappetein, A. P., et al. (2008) · European Journal of Cardio-Thoracic Surgery · doi:10.1016/j.ejcts.2008.04.039 · Cited by 305 · see citing works
Principles and Practice of Geriatric Medicine
(2005) · Wiley eBooks · doi:10.1002/047009057x · Cited by 303 · see citing works
Sinning, J., Ghanem, A., Steinhäuser, H., Adenauer, V., Hammerstingl, C., Nickenig, G., & Werner, N. (2010) · JACC: Cardiovascular Interventions · doi:10.1016/j.jcin.2010.09.009 · Cited by 302 · see citing works
Aortic Valve Replacement in Octogenarians: Utility of Risk Stratification With EuroSCORE
Leontyev, S., Walther, T., Borger, M. A., Lehmann, S., Funkat, A. K., Rastan, A. J., Kempfert, J., Falk, V., & Mohr, F. W. (2009) · The Annals of Thoracic Surgery · doi:10.1016/j.athoracsur.2009.01.057 · Cited by 207 · see citing works
Rosenhek, R., Iung, B., Tornos, P., Antunes, M. J., Prendergast, B. D., Otto, C. M., Kappetein, A. P., Stepinska, J., Kaden, J. J., Naber, C. K., et al. (2011) · European Heart Journal · doi:10.1093/eurheartj/ehr061 · Cited by 188 · see citing works
Acute coronary syndromes in young patients: Presentation, treatment and outcome
Schoenenberger, A. W., Radovanović, D., Stauffer, J., Windecker, S., Urban, P. M., Niedermaier, G., Keller, P., Gutzwiller, F., & Erné, P. (2009) · International Journal of Cardiology · doi:10.1016/j.ijcard.2009.11.009 · Cited by 180 · see citing works
Self-citationClough‐Gorr, K. M., Stuck, A. E., Thwin, S. S., & Silliman, R. A. (2009) · Journal of Clinical Oncology · doi:10.1200/jco.2009.23.5440 · Cited by 177 · see citing works
Self-citationFukuse, T., Satoda, N., Hijiya, K., & Takuji, F. (2005) · CHEST Journal · doi:10.1378/chest.127.3.886 · Cited by 171 · see citing works
Piazza, N., Wenaweser, P., van Gameren, M., Pilgrim, T., Tsikas, A., Otten, A., Nuis, R. J., Onuma, Y., Cheng, J. M., Kappetein, A. P., et al. (2010) · American Heart Journal · doi:10.1016/j.ahj.2009.11.026 · Cited by 166 · see citing works
Self-citationWenaweser, P., Pilgrim, T., Roth, N., Kadner, A., Stortecky, S., Kalesan, B., Meuli, F., Büllesfeld, L., Khattab, A. A., Huber, C. H., et al. (2011) · American Heart Journal · doi:10.1016/j.ahj.2011.01.025 · Cited by 127 · see citing works
Self-citationSchoenenberger, A. W., Radovanović, D., Stauffer, J., et al. (2008) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.2007.01589.x · Cited by 117 · see citing works
Self-citationGotzmann, M., Pljakic, A., Bojara, W., Lindstaedt, M., Ewers, A., Germing, A., & Mügge, A. (2011) · American Heart Journal · doi:10.1016/j.ahj.2011.05.011 · Cited by 113 · see citing works
The Prognostic Significance of Protein-energy Malnutrition in Geriatric Patients
MÜHLETHALER, R., Stuck, A. E., Minder, C. E., & Frey, B. M. (1995) · Age and Ageing · doi:10.1093/ageing/24.3.193 · Cited by 112 · see citing works
Self-citationMultidimensional Geriatric Assessment
Rubenstein, L. Z., & Stuck, A. E. (2012) · Pathy's Principles and Practice of Geriatric Medicine · doi:10.1002/9781119952930.ch112 · Cited by 56 · see citing works
Self-citationComponents of Geriatric Assessments Predict Thoracic Surgery Outcomes
Kothari, A. N., Phillips, S. M., Bretl, T., et al. (2010) · Journal of Surgical Research · doi:10.1016/j.jss.2010.05.050 · Cited by 44 · see citing works
Schoenenberger, A. W., Kobza, R., Jamshidi, P., Züber, M., Abbate, A., Stuck, A. E., Pfisterer, M. E., & Erné, P. (2009) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2009.03.019 · Cited by 31 · see citing works
Self-citation
Flagged first, then by citations
Cited by
Sorted by citations
Frailty Assessment in the Cardiovascular Care of Older Adults
Afilalo, J., Alexander, K. P., Mack, M. J., Maurer, M. S., Green, P., Allen, L. A., Popma, J. J., Ferrucci, L., & Forman, D. E. (2014) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2013.09.070 · Cited by 1,173 · see citing works
Lindman, B. R., Clavel, M.-A., Mathieu, P., Iung, B., Lancellotti, P., Otto, C. M., & Pibarot, P. (2016) · Nature Reviews Disease Primers · doi:10.1038/nrdp.2016.6 · Cited by 982 · see citing works
Schoenenberger, A. W., Stortecky, S., Neumann, S., Moser, A., Juni, P., Carrel, T., Huber, C., Gandon, M., Bischoff, S., Schoenenberger, C.-M., et al. (2013) · European Heart Journal · doi:10.1093/eurheartj/ehs304 · Cited by 299 · see citing works
Self-citationFutility, Benefit, and Transcatheter Aortic Valve Replacement
Lindman, B. R., Alexander, K. P., O'Gara, P. T., & Afilalo, J. (2014) · JACC: Cardiovascular Interventions · doi:10.1016/j.jcin.2014.01.167 · Cited by 222 · see citing works
Stefanini, G. G., Stortecky, S., Cao, D., Rat-Wirtzler, J., O'Sullivan, C. J., Gloekler, S., Buellesfeld, L., Khattab, A. A., Nietlispach, F., Pilgrim, T., et al. (2014) · European Heart Journal · doi:10.1093/eurheartj/ehu074 · Cited by 190 · see citing works
Self-citation
- Authors
- Stortecky, S., Schoenenberger, A. W., Moser, A., Kalesan, B., Jüni, P., Carrel, T., Bischoff, S., Schoenenberger, C.-M., Stuck, A. E., Windecker, S., & Wenaweser, P.
- Affiliations
- University Hospital of Bern (CH)
- University of Bern (CH)
- Corresponding author
- Windecker, Stephan
- ORCID
- Venue
- JACC: Cardiovascular Interventions
- Publisher
- Elsevier BV
- Published
- 2012-05
- Volume
- 5
- Issue
- 5
- Pages
- 489-496
- ISSN
- 1876-7605 (ISSN-L)
- 1936-8798
- OpenAlex
- W1964471691
- Cited by
- 332
- References
- 38
- Citations by year
- 2026: 5 · 2025: 7 · 2024: 12 · 2023: 17 · 2022: 19 · 2021: 17 · 2020: 33 · 2019: 37 · 2018: 33 · 2017: 27 · 2016: 40 · 2015: 30 · 2014: 27 · 2013: 21 · 2012: 7
- FWCI
- 17.47
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- JACC: Cardiovascular Interventions (publishedVersion)
- PubMed (publishedVersion)
- Bern Open Repository and Information System (University of Bern) (submittedVersion)
- Funders
- Bern University Hospital
- Swiss National Science Foundation (32003B_135807)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Valve Diseases and Treatments
- Health Sciences › Medicine › Geriatrics and Gerontology › Frailty in Older Adults
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Aortic Disease and Treatment Approaches
- Keywords
- multidimensional geriatric assessment, transcatheter aortic valve implantation, mortality prediction, major adverse cardiac and cerebrovascular events, frailty index, cognitive impairment, malnutrition, mobility impairment, activities of daily living, STS score, EuroSCORE, elderly patients, postoperative outcomes, risk stratification, instrumental activities of daily living
- MeSH terms
- Activities of Daily Living, Age Factors, Aged, Aged, 80 and over, Aortic Valve Stenosis, Cerebrovascular Disorders, Cognition, Female, Cardiac Catheterization, Humans, Male, Nutritional Status, Predictive Value of Tests, Prospective Studies, Risk Factors, Switzerland, Time Factors, Geriatric Assessment, Multivariate Analysis, Linear Models, Logistic Models, Odds Ratio, Frail Elderly, Treatment Outcome, Risk Assessment, Heart Valve Prosthesis Implantation, Mobility Limitation
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
