Are Octogenarians in Good Condition after Cardiac Valvular Surgery?

Reportedly, males take fewer steps than females among frail older adults. The step count of frail older adults may be influenced by domestic roles in the instrumental activities of daily living. In this study, we aimed to investigate the association between instrumental activities of daily living and the number of steps in frail older females. [Participants and Methods] In this cross-sectional study, we included 27 frail older females aged 84.4 ± 6.5 years who attended a day-care center. We used the Fillenbaum's instrumental activities of daily living screener and measured the number of steps using an accelerometer, functional independence measure, grip strength, and short physical performance battery. We investigated the association between instrumental activities of daily living and daily steps. Furthermore, we compared the outcomes of the differences in the independence using a subscale of instrumental activities of daily living. [Results] Instrumental activities of daily living and step counts showed a significant correlation. Participants dependent on meal preparation and housework took significantly fewer steps per day. The dependence of their activities also caused low functional independence measure and weak grip strength. [Conclusion] In frail older females, decreased ability for instrumental activities of daily living were associated with fewer steps. Domestic roles may increase the daily steps in frail older adults.

show abstract

“…When some kind of assistance is needed, they receive 0 point. More than 4 points reflect high independence in IADL13 ) .…”

Section: Participants and Methodsmentioning

confidence: 99%

Instrumental activities of daily living and number of daily steps in frail older females

et al. 2019

View full text Add to dashboard Cite

show abstract

“…Sumi, et al reported that in octogenarians with independent activities of daily living before surgery, cardiac valvular surgery was safe and postoperative quality of life was satisfactory. 26) It would be necessary for us to discuss the benefit of surgery for each patient in a heart team including cardiologists, cardiac surgeons, and other healthcare professionals.…”

Section: Discussionmentioning

confidence: 99%

Characteristics of Inoperable Patients with Severe Aortic Valve Stenosis —In the Era of Transcatheter Aortic Valve Replacement

Seki

Sakakibara

Shingu

et al. 2015

ATCS

View full text Add to dashboard Cite

Purpose: Transcatheter aortic valve replacement (TAVR) has emerged as a therapeutic option for severe aortic valvular stenosis (AS). To determine the indication for TAVR, it is mandatory to clarify the characteristics of the patients who were judged as inoperable for conventional aortic valve replacement (cAVR). Methods: Of 185 patients newly diagnosed as severe AS from March 2010 to April 2011, we studied the characteristics of 61 (33%) patients (mean age, 86 ± 8 years) who were judged as inoperable. Results: Younger patients (<85 years old, n = 22) had more major comorbidities and lower left ventricular ejection fraction than older patients (≥85 years old, n = 39). Mean estimated mortality for cAVR by Japan score was 7.0% ± 7.4%. Japan score did not correlate to age and was calculated relatively low in the older age group (6.2% ± 7.0%) than the younger age group (8.3% ± 8.1%). Conclusion: One thirds of severe AS patients were judged as inoperable. In advanced age patients, age itself and other factors, which are not included in the conventional scoring systems, might have contributed to the decision making not to perform cAVR by cardiologists. Further study is necessary to define risk factors except for age.

show abstract

“…4,5 Various studies have reported worse outcomes in octogenarians; however, these reports have been primarily situated within the cardiac surgery literature. [6][7][8][9][10][11] Data on postoperative outcomes in octogenarians after vascular surgery, on the other hand, has been sparse and anecdotal.…”

Section: Introductionmentioning

confidence: 99%

Multi-institutional outcomes after femoropopliteal bypass in octogenarians

et al. 2022

View full text Add to dashboard Cite

Objectives Open lower extremity revascularization is controversial among octogenarians; however, the indications for surgical bypass are higher in the elderly population. The aim of the study was to compare postoperative outcomes between octogenarians and non-octogenarians following femoropopliteal bypass surgery. Methods Our regional, multi-institutional database was queried for femoropopliteal bypass procedures performed between 1995 and 2020. Electronic medical records were individually reviewed for operative and postoperative data. Univariable and multivariable logistic regression were utilized to determine predictors of postoperative outcomes. Results Among 1315 patients who underwent femoropopliteal bypass, 234 (17.8%) were octogenarians. Octogenarians more frequently underwent bypass for lower extremity tissue loss (48.7% vs 30.2%), whereas claudication was more common among non-octogenarians (24.0% vs 9.8%) ( p < .001). Below-knee bypass target (72.2% vs 59.3%) and prosthetic conduit utilization (58.5% vs 43.7%) were more frequent in octogenarians ( p < .001 each). Overall hospital length of stay was longer among patients > 80 years (median 6 days [interquartile range [IQR] 4–9] vs 5 days [IQR 4–8], p = .017). The overall 30-day (5.6% vs 1.5%) and one-year mortality rates (25.6% vs 7.9%) were higher among octogenarians ( p < .001 each). On multivariable analysis, age greater than 80 years was found to be an independent risk factor for postoperative mortality (OR 3.79 [1.75–8.20], p = .0007) Conclusions Octogenarians undergoing bypass femoropopliteal bypass surgery have considerably worse postoperative outcomes, compared with non-octogenarians. These data may help inform elderly patients prior to undergoing open lower extremity revascularization.

show abstract

Are Octogenarians in Good Condition after Cardiac Valvular Surgery?

Cited by 7 publications

References 14 publications

Instrumental activities of daily living and number of daily steps in frail older females

Instrumental activities of daily living and number of daily steps in frail older females

Characteristics of Inoperable Patients with Severe Aortic Valve Stenosis —In the Era of Transcatheter Aortic Valve Replacement

Multi-institutional outcomes after femoropopliteal bypass in octogenarians

Contact Info

Product

Resources

About