Frailty Index is Associated with Adverse Outcomes after Aortic Valve Replacement in Elderly Patients
Journal of Korean Medical Science
;
: e205-2019.
Artigo
em Inglês
| WPRIM
| ID: wpr-765041
ABSTRACT
BACKGROUND:
This study was conducted to evaluate the prognostic value of the frailty index based on routine laboratory data (FI-L) in elderly patients who underwent surgical aortic valve replacement (SAVR).METHODS:
A total of 154 elderly patients (≥ 75 years) (78.7 ± 3.6 years; menwomen = 7876) who underwent aortic valve replacement with stented bioprosthesis between 2001 and 2018 were enrolled. The FI-L was calculated as the proportion of abnormal results out of 32 items based on laboratory tests, pulse rate and blood pressure. The primary outcome was all-cause mortality. Secondary outcomes included operative mortality and aortic valve-related events (AVREs) during follow-up. The predictive values of FI-L for the early and late outcomes were evaluated using logistic regression and Cox proportional hazards models, respectively. The median follow-up duration was 40 months (interquartile, 15–74).RESULTS:
The operative mortality rate was 3.9% (n = 6). Late death occurred in 29 patients. The overall survival (OS) rates at 5, 10, and 15 years were 83.3%, 59.0%, and 41.6%, respectively. The AVREs occurred in 28 patients and the freedom rates from AVREs at 5, 10, and 15 years were 79.4%, 72.7%, and 52.9%, respectively. Multivariable analyses demonstrated that FI-L was a significant factor for OS (hazard ratio, 1.075; 95% confidence interval, 1.040–1.111). A minimal P value approach showed that a FI-L of 25% was the best cutoff value to predict OS after SAVR.CONCLUSION:
The FI-L is significantly associated with early and long-term outcomes after SAVR in elderly patients. Frailty rather than a patient's age should be considered in the decision-making process for SAVR in elderly patients.
Texto completo:
DisponíveL
Índice:
WPRIM (Pacífico Ocidental)
Assunto principal:
Valva Aórtica
/
Estenose da Valva Aórtica
/
Bioprótese
/
Pressão Sanguínea
/
Modelos Logísticos
/
Modelos de Riscos Proporcionais
/
Stents
/
Seguimentos
/
Mortalidade
/
Liberdade
Tipo de estudo:
Estudo observacional
/
Estudo prognóstico
/
Fatores de risco
Limite:
Idoso
/
Humanos
Idioma:
Inglês
Revista:
Journal of Korean Medical Science
Ano de publicação:
2019
Tipo de documento:
Artigo
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