Predictors of functional decline in elderly patients undergoing transcatheter aortic valve implantation (TAVI)
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Aims This study aimed to assess functional course in elderly patients undergoing transcatheter aortic valve implantation (TAVI) and to find predictors of functional decline. Methods and results In this prospective cohort, functional course was assessed in patients ≥70 years using basic activities of daily living (BADL) before and 6 months after TAVI. Baseline EuroSCORE, STS score, and a frailty index (based on assessment of cognition, mobility, nutrition, instrumental and basic activities of daily living) were evaluated to predict functional decline (deterioration in BADL) using logistic regression models. Functional decline was observed in 22 (20.8%) of 106 surviving patients. EuroSCORE (OR per 10% increase 1.18, 95% CI: 0.83-1.68, P = 0.35) and STS score (OR per 5% increase 1.64, 95% CI: 0.87-3.09, P = 0.13) weakly predicted functional decline. In contrast, the frailty index strongly predicted functional decline in univariable (OR per 1 point increase 1.57, 95% CI: 1.20-2.05, P = 0.001) and bivariable analyses (OR: 1.56, 95% CI: 1.20-2.04, P = 0.001 controlled for EuroSCORE; OR: 1.53, 95% CI: 1.17-2.02, P = 0.002 controlled for STS score). Overall predictive performance was best for the frailty index [Nagelkerke's R(2) (NR(2)) 0.135] and low for the EuroSCORE (NR(2) 0.015) and STS score (NR(2) 0.034). In univariable analyses, all components of the frailty index contributed to the prediction of functional decline. Conclusion Over a 6-month period, functional status worsened only in a minority of patients surviving TAVI. The frailty index, but not established risk scores, was predictive of functional decline. Refinement of this index might help to identify patients who potentially benefit from additional geriatric interventions after TAVI.
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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 [255]
The Discussion (page unavailable) reports that frailty before TAVI predicts functional decline and that a previous analysis of the same cohort linked the frailty index to mortality. The paper treats functional status as a component of quality of life, but it does not establish that poor health is principally due to comorbidities or geriatric conditions, or directly measure a decline or lack of improvement in quality of life after TAVI. (LLM, conf=0.84)
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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
Assessment of Older People: Self-Maintaining and Instrumental Activities of Daily Living
Lawton, M. P., & Brody, E. M. (1969) · The Gerontologist · doi:10.1093/geront/9.3_part_1.179 · Cited by 18,540 · 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
Assessing the Performance of Prediction Models: A Framework for Traditional and Novel Measures
Steyerberg, E. W., Vickers, A. J., Cook, N. R., Gerds, T., Gonen, M., Obuchowski, N., Pencina, M. J., & Kattan, M. W. (2010) · Epidemiology · doi:10.1097/ede.0b013e3181c30fb2 · Cited by 5,170 · see citing works
Norman, G. R., Sloan, J. A., & Wyrwich, K. W. (2003) · Medical Care · doi:10.1097/01.mlr.0000062554.74615.4c · Cited by 4,700 · 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
Katz, 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
Fried, 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
Drozdzowska, B., Pluskiewicz, W., Halaba, Z. P., Misiołek, H., & Beck, B. R. (2005) · Cited by 984 · 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
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 Heart Journal · doi:10.1093/eurheartj/ehn183 · Cited by 720 · see citing works
The Identification of Frailty: A Systematic Literature Review
Sternberg, S. A., Schwartz, A. W., Karunananthan, S., Bergman, H., & Mark Clarfield, A. (2011) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.2011.03597.x · Cited by 703 · see citing works
Lee, 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 676 · see citing works
Bachmann, S., Finger, C., Huss, A., Egger, M., Stuck, A. E., & Clough‐Gorr, K. M. (2010) · BMJ · doi:10.1136/bmj.c1718 · Cited by 542 · see citing works
Self-citationRostoft, 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
One year follow-up of the multi-centre European PARTNER transcatheter heart valve study
Lefèvre, T., Kappetein, A. P., Wolner, E., Nataf, P., Thomas, M., Schächinger, V., Bruyne, B. D., Eltchaninoff, H., Thielmann, M., Himbert, D., et al. (2010) · European Heart Journal · doi:10.1093/eurheartj/ehq427 · Cited by 376 · see citing works
Stortecky, S., Schoenenberger, A. W., Moser, A., Kalesan, B., Jüni, P., Carrel, T., Bischoff, S., Schoenenberger, C.-M., Stuck, A. E., Windecker, S., et al. (2012) · JACC: Cardiovascular Interventions · doi:10.1016/j.jcin.2012.02.012 · Cited by 332 · see citing works
Self-citationReynolds, M. R., Magnuson, E. A., Lei, Y., Leon, M. B., Smith, C. R., Svensson, L. G., Webb, J. G., Babaliaros, V. C., Bowers, B. S., Fearon, W. F., et al. (2011) · Circulation · doi:10.1161/circulationaha.111.040022 · Cited by 318 · see citing works
Principles and Practice of Geriatric Medicine
(2005) · Wiley eBooks · doi:10.1002/047009057x · Cited by 303 · see citing works
Singh, M., Rihal, C. S., Lennon, R. J., Spertus, J. A., Nair, K. S., & Roger, V. L. (2011) · Circulation Cardiovascular Quality and Outcomes · doi:10.1161/circoutcomes.111.961375 · Cited by 261 · see citing works
Clough‐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-citationDiMaria-Ghalili, R. A., & Guenter, P. (2008) · AJN American Journal of Nursing · doi:10.1097/01.naj.0000308962.37976.c9 · Cited by 173 · see citing works
Fukuse, T., Satoda, N., Hijiya, K., & Takuji, F. (2005) · CHEST Journal · doi:10.1378/chest.127.3.886 · Cited by 171 · see citing works
Wenaweser, P., Pilgrim, T., Kadner, A., Huber, C. H., Stortecky, S., Buellesfeld, L., Khattab, A. A., Meuli, F., Roth, N., Eberle, B., et al. (2011) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2011.05.063 · Cited by 146 · see citing works
Self-citationRisk Factors Promoting Hypertensive Crises: Evidence From a Longitudinal Study
Saguner, A. M., Dür, S., Perrig, M., Schiemann, U., Stuck, A. E., Bürgi, U., Erné, P., & Schoenenberger, A. W. (2010) · American Journal of Hypertension · doi:10.1038/ajh.2010.71 · Cited by 134 · 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-citationSánchez, E., Vidán, M. T., Rexach, J. A. S., Fernández‐Avilés, F., & Bueno, H. (2011) · Heart · doi:10.1136/hrt.2011.227504 · Cited by 127 · see citing works
Philippova, M., Suter, Y., Toggweiler, S., Schoenenberger, A. W., Joshi, M. B., Kyriakakis, E., Erné, P., & Resink, T. J. (2010) · European Heart Journal · doi:10.1093/eurheartj/ehq206 · Cited by 57 · 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
Gender-related ADL performance of old people recently admitted to a Swiss nursing home
Bürge, E. (2011) · Swiss Medical Weekly · doi:10.4414/smw.2011.13183 · Cited by 10 · see citing works
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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
Wang, D. X. M., Yao, J., Zirek, Y., Reijnierse, E. M., & Maier, A. B. (2020) · Journal of Cachexia, Sarcopenia and Muscle · doi:10.1002/jcsm.12502 · Cited by 655 · see citing works
Futility, 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
- Authors
- Schoenenberger, A. W., Stortecky, S., Neumann, S., Moser, A., Juni, P., Carrel, T., Huber, C., Gandon, M., Bischoff, S., Schoenenberger, C.-M., Stuck, A. E., Windecker, S., & Wenaweser, P.
- Affiliations
- University of Bern (CH)
- University Hospital of Bern (CH)
- Corresponding author
- Windecker, S.
- Venue
- European Heart Journal
- Publisher
- Oxford University Press (OUP)
- Published
- 2012-09-24
- Volume
- 34
- Issue
- 9
- Pages
- 684-692
- ISSN
- 0195-668X (ISSN-L)
- 1522-9645
- OpenAlex
- W2133538151
- Cited by
- 299
- References
- 38
- Citations by year
- 2026: 6 · 2025: 8 · 2024: 9 · 2023: 12 · 2022: 16 · 2021: 15 · 2020: 30 · 2019: 35 · 2018: 36 · 2017: 22 · 2016: 36 · 2015: 30 · 2014: 29 · 2013: 14 · 2012: 1
- FWCI
- 15.23
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- European Heart Journal (publishedVersion)
- PubMed (publishedVersion)
- Archive ouverte UNIGE (University of Geneva) (publishedVersion, other-oa)
- reroDoc Digital Library (submittedVersion)
- Bern Open Repository and Information System (University of Bern) (submittedVersion, other-oa)
- Open Access CRIS of the University of Bern
- Funders
- National Science Foundation
- Edwards Lifesciences
- Inselspital, Universitätsspital Bern
- Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung (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
- transcatheter aortic valve implantation, functional decline, elderly patients, frailty index, EuroSCORE, Society of Thoracic Surgeons risk score, activities of daily living, postoperative functional outcomes, risk prediction, geriatric intervention
- MeSH terms
- Activities of Daily Living, Aged, Aged, 80 and over, Aortic Valve, Aortic Valve Stenosis, Female, Cardiac Catheterization, Heart Valve Prosthesis, Humans, Male, Prospective Studies, Quality of Life, Geriatric Assessment, Frail Elderly, Treatment Outcome, Heart Valve Prosthesis Implantation
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