Frailty is associated with delirium and mortality after transcatheter aortic valve implantation.
Open Heart
; 3(2): e000478, 2016.
Article
em En
| MEDLINE
| ID: mdl-28008356
ABSTRACT
OBJECTIVE:
We hypothesised that frailty assessment is of additional value to predict delirium and mortality after transcatheter aortic valve implantation (TAVI).METHODS:
Observational study in 89 consecutive patients who underwent TAVI. Inclusion from November 2012 to February 2014, follow-up until April 2014. Measurement of the association of variables from frailty assessment and cardiological assessment with delirium and mortality after TAVI, respectively.RESULTS:
Incidence of delirium after TAVI 25/89 (28%). Variables from frailty assessment protectively associated with delirium were Mini Mental State Examination, (OR 0.79; 95% CI 0.65 to 0.96; p=0.02), Instrumental Activities of Daily Living (OR 0.79; 95% CI 0.63 to 0.99; p=0.04) and gait speed (OR 0.05; 95% CI 0.01 to 0.50; p=0.01). Timed Up and Go was predictively associated with delirium (OR 1.14; 95% CI 1.03 to 1.26; p=0.01). From cardiological assessment, pulmonary hypertension was protectively associated with delirium (OR 0.34; 95% CI 0.12 to 0.98; p=0.05). Multivariate logisticanalysis:
Nagelkerke R2=0.359, Mini Mental State Examination was independently associated with delirium. Incidence of mortality 11/89 (12%). Variables predictively associated with mortality were the summary score Frailty Index (HR 1.66, 95% CI 1.06 to 2.60; p=0.03), European System for Cardiac Operative Risk Evaluation (EuroSCORE) II (HR 1.14, 95% CI 1.06 to 1.22; p<0.001) and complications (HR 4.81, 95% CI 1.03 to 22.38; p=0.05). Multivariate Cox proportional hazardsanalysis:
Nagelkerke R2=0.271, Frailty Index and EuroSCORE II were independently associated with mortality.CONCLUSIONS:
Delirium frequently occurs after TAVI. Variables from frailty assessment are associated with delirium and mortality, independent of cardiological assessment. Thus, frailty assessment may have additional value in the prediction of delirium and mortality after TAVI.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Tipo de estudo:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Idioma:
En
Revista:
Open Heart
Ano de publicação:
2016
Tipo de documento:
Article
País de afiliação:
Holanda