Frailty

Søndergaard, Lars; Kirk, Bettina Højberg; Jørgensen, Troels Højsgaard

doi:10.1016/j.jcin.2017.12.017

Cited by 6 publications

(3 citation statements)

References 17 publications

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“…7,11 So far, it has been demonstrated so far that the frailty syndrome is an independent predictor of death mainly in the elderly patients with aortic stenosis undergoing interventional treatment as well as in the group of patients with mitral regurgitation treated percutaneously. 7,11,17,20 Also described that frailty indices such as 5-m walk test, Elderly Mobility Scale and handgrip strength as well as normalized values of psoas muscle area (PSA) and psoas muscle volume (PSV) using computed tomography (CT) scans were characterized by strong prediction ability of occurrence death after transcatheter aortic valve implantation (TAVI) in long-term follow-up. 21,22 However, there is no unambiguous information on the impact of the onset of the frailty syndrome in the early postoperative period in the general group of symptomatic patients undergoing heart valve surgery.…”

Section: Discussionmentioning

confidence: 99%

<p>Usefulness of FRAIL Scale in Heart Valve Diseases</p>

Duchnowski¹,

Szymański²,

Kuśmierczyk³

et al. 2020

CIA

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Background The frailty syndrome is a serious health problem for an aging population. The occurrence of frailty in the group of symptomatic patients undergoing heart valve surgery may have additional clinical implications. The predictive ability of the FRAIL scale in patients undergoing heart valve surgery during a 30-day follow-up has not yet been described. Patients and Methods A prospective study was conducted on a group of consecutive patients with hemodynamically significant valve disease (aortic stenosis, aortic regurgitation, mitral stenosis and mitral regurgitation) that underwent elective valve surgery in 2014–2019. The primary endpoint was 30-day mortality. Univariate analysis, followed by multivariate regression analysis, was performed. Results The study group included 672 consecutive patients (aortic valve stenosis, aortic regurgitation, mitral stenosis and mitral regurgitation) who underwent replacement or repair of the valve. Twenty-five patients died during the 30-day follow-up. At multivariate analysis, FRAIL scale result (OR 2.802; 95% CI 1.275–6.157; p=0.01) and red cell distribution width (RDW) (OR 1.810; 95% CI 1.181–2.775; p=0.006) remained independent predictors of the primary endpoint. Conclusion The presented study showed the predictive ability of the FRAIL scale result in patients undergoing heart valve surgery for 30-day mortality.

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Section: Discussionmentioning

confidence: 99%

<p>Usefulness of FRAIL Scale in Heart Valve Diseases</p>

Duchnowski¹,

Szymański²,

Kuśmierczyk³

et al. 2020

CIA

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“…Previous studies have analyzed factors such as age, cognitive impairment, physical weakness, and also laboratory values such as anemia and hypoalbuminemia [9]. There is a great heterogeneity in clinical vulnerability, including nutritional status, physical and cognitive impairment, and psychosocial risk factors [10].…”

Section: Introductionmentioning

confidence: 99%

Total Muscle Area and Visceral Adipose Tissue Measurements for Frailty Assessment in TAVR Patients

Demirel,

Rothenbühler,

Huber

et al. 2024

JCM

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Background: Transcatheter aortic valve replacement (TAVR) is a treatment option for severe aortic valve stenosis. Pre-TAVR assessments, extending beyond anatomy, include evaluating frailty. Potential frailty parameters in pre-TAVR computed tomography (CT) scans are not fully explored but could contribute to a comprehensive frailty assessment. The primary objective was to investigate the impact of total muscle area (TMA) and visceral adipose tissue (VAT) as frailty parameters on 5-year all-cause mortality in patients undergoing TAVR. Methods: Between 01/2017 and 12/2018, consecutive TAVR patients undergoing CT scans enabling TMA and VAT measurements were included. Results: A total of 500 patients qualified for combined TMA and VAT analysis. Age was not associated with a higher risk of 5-year mortality (HR 1.02, 95% CI: 0.998–1.049; p = 0.069). Body surface area normalized TMA (nTMA) was significantly associated with 5-year, all-cause mortality (HR 0.927, 95% CI: 0.927–0.997; p = 0.033), while VAT had no effect (HR 1.002, 95% CI: 0.99–1.015; p = 0.7). The effect of nTMA on 5-year, all-cause mortality was gender dependent: the protective effect of higher nTMA was found in male patients (pinteraction: sex × nTMA = 0.007). Conclusions: Normalized total muscle area derived from a routine CT scan before transcatheter aortic valve replacement complements frailty assessment in patients undergoing TAVR.

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“…However, estimating frailty poses a significant challenge in clinical practice due to its multifactorial nature, which encompasses various aspects of vulnerability, including nutritional status, physical and cognitive impairments, and laboratory values [8,9]. This complexity underscores the need for a comprehensive assessment approach that considers the diverse factors contributing to frailty.…”

Section: Introductionmentioning

confidence: 99%

Low Bone Mineral Density on Computed Tomography: Association with Poor Survival after Transcatheter Aortic Valve Replacement

Demirel,

Halavina,

Hamzaraj

et al. 2024

JCM

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Background: Transcatheter aortic valve replacement (TAVR) has evolved as first-line therapy for severe aortic valve stenosis (AS), with pre-procedural computed tomography (CT) providing critical anatomical information. While primarily used for anatomical planning, TAVR-CT also offers an opportunity to assess low bone mineral density (BMD), a known indicator of frailty. Despite this, the prognostic role of BMD in TAVR patients remains unknown. This study aimed to evaluate BMD on routine TAVR-CT and its impact on long-term survival. Methods: In this retrospective study, 770 consecutive TAVR patients (mean age 80.7 ± 6.7 years, 54.0% males) between November 2015 and March 2022 were included. BMD was measured from a single axial image at the thoracic vertebral level on unenhanced CT scans. Cox regression models assessed the impact of BMD on mortality, and Restricted Cubic Spline models identified potential mortality thresholds. Results: The mean BMD value, as measured on non-contrast CT, was 147.5 ± 5.4 Hounsfield units, demonstrating a noteworthy association with mortality (adjusted hazard ratio per 100 HU decrease: 1.27 [95% CI: 1.01–1.59], p = 0.041). Restricted cubic spline analysis indicated that BMD below 200 HU was linked to a substantial increase in mortality risk. Upon crude Cox regression analysis, every 100 HU decrease was associated with a 32% increase in risk for death (HR 1.32 [95%CI: 1.068–1.65)], p = 0.010). Conclusions: In conclusion, low BMD on TAVR-CT is independently associated with reduced survival, suggesting its potential as a tool for comprehensive frailty assessment and improved risk prediction in TAVR patients.

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Frailty

Cited by 6 publications

References 17 publications

<p>Usefulness of FRAIL Scale in Heart Valve Diseases</p>

<p>Usefulness of FRAIL Scale in Heart Valve Diseases</p>

Total Muscle Area and Visceral Adipose Tissue Measurements for Frailty Assessment in TAVR Patients

Low Bone Mineral Density on Computed Tomography: Association with Poor Survival after Transcatheter Aortic Valve Replacement

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