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Frailty Status and Patient-Reported Outcomes in Octogenarians Following Transcatheter or Surgical Aortic Valve Replacement
Haukeland University Hospital, Norway.
Western Norway University of Applied Sciences, Norway.ORCID iD: 0000-0001-7216-6470
Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Haukeland University Hospital, Norway. (Ctr Interprofess Collaborat Emergency Care CICE)
Haukeland University Hospital, Norway;University of Bergen, Norway.
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2021 (English)In: Heart, Lung and Circulation, ISSN 1443-9506, E-ISSN 1444-2892, Vol. 30, no 8, p. 1221-1231Article in journal (Refereed) Published
Sustainable development
SDG 3: Ensure healthy lives and promote well-being for all at all ages
Abstract [en]

Background

Frailty status and patient-reported outcomes are especially pertinent in octogenarians following transcatheter aortic valve implantation (TAVI) and surgical aortic valve replacement (SAVR) to guide treatment decisions and promote patient-centred care.

Aim

We aimed to determine if frailty changed 6 months after aortic valve replacement (AVR) in octogenarians, and to describe changes in self-rated health according to frailty status in patients who underwent TAVI or SAVR.

Method

In a prospective cohort study, frailty and self-rated health were measured one day prior to and 6 months after AVR. Frailty status was measured with the Study of Osteoporotic Fracture index. Self-rated health was measured comprehensively with the disease-specific Minnesota Living with Heart Failure Questionnaire, the generic Medical Outcomes Study Short Form-12 questionnaire (SF-12), and two global questions from The World Health Organization Quality of Life Instrument Abbreviated.

Results

Data were available for 143 consecutive patients (mean age 83 +/- 2.7 years, 57% women; 45% underwent TAVI). At baseline, 34% were robust, 27% prefrail, and 39% frail. Overall, there was no change in the distribution of frailty status 6 months after baseline (p=0.13). However, on an individual level 65 patients changed frailty status after AVR (40 patients improved and 25 declined). Improvement in frailty status was common in prefrail (33%; n=13) and frail patients (48%; n=27). Patients had improved self-rated health after AVR, with significant differences between frailty states both at baseline (SF-12 physical: 37.4 [robust], 33.1 [prefrail], 31.6 [frail], p=0.03); SF-12 mental: 51.9 [robust], 50.8 [prefrail], 44.5 [frail], p<0.001); and at the 6-month follow-up (SF-12 physical: 45.4 [robust], 38.3 [prefrail], 32.1 [frail], p<0.001); SF-12 mental: 54.9 [robust], 49.6 [prefrail], 46.8 [frail], p=0.002).

Conclusions

Advanced treatment performed in a high-risk population allowed people to improve their self-rated health. Although frailty is associated with poor self-rated health, frailty status does not equal negative outcomes. The frail patients were those who improved most in self-rated physical and mental health. They had the lowest baseline self-rated health scores and had therefore the most to gain.

Place, publisher, year, edition, pages
Elsevier, 2021. Vol. 30, no 8, p. 1221-1231
Keywords [en]
Frailty, Octogenarians, Aortic valve stenosis, Health status, Patient-reported outcome measures, Transcatheter aortic valve implantation, Surgical aortic valve replacement
National Category
Cardiology and Cardiovascular Disease
Research subject
Health and Caring Sciences, Nursing
Identifiers
URN: urn:nbn:se:lnu:diva-106678DOI: 10.1016/j.hlc.2020.10.024ISI: 000668260100022PubMedID: 33714672Scopus ID: 2-s2.0-85103423208Local ID: 2021OAI: oai:DiVA.org:lnu-106678DiVA, id: diva2:1590103
Available from: 2021-09-01 Created: 2021-09-01 Last updated: 2025-02-10Bibliographically approved

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Fridlund, Bengt

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