Patient-reported outcomes after referral for possible valve replacement in patients with severe aortic stenosis

Abstract

www.clinicaltrials.gov (NCT01794832).

The impact of surgical aortic valve replacement on quality of life—a multicenter study

“…[25][26][27] In future studies, it will be challenging to highlight patient-related outcomes such as QoL when deciding between TAVR and SAVR, due to variability in patients' individual values and preferences. 23 A factor that might explain why elderly patients report a decline in QoL is that in our study, as well as in another recent study, 21 age is associated with a lower QoL after cardiac surgery. In other words, patients undergoing SAVR at an elderly age are at greater risk of experiencing a worse QoL compared with younger patients.…”

“…We interpreted this finding as regression to the mean, which has been confirmed in other studies on QoL after cardiac surgery. 9,21,28 To correct for this finding, we included baseline QoL scores in the multivariable regression analyses. Other explanations might be residual confounding due to differences in baseline characteristics.…”

“…In our study, renal disease and female sex were not associated with an impaired QoL, whereas other studies did suggest these factors as predictors for impaired QoL after SAVR. 21,29 We included patients undergoing SAVR with or without concomitant revascularization to increase groups. Subgroup analyses show that although patients with solitary SAVR on average experience a greater physical and mental QoL, change in QoL was not significantly different between both groups.…”

“…Sensitivity analyses were conducted using a MCID of 4 points. 21 Linear regression analysis was conducted to evaluate the impact of age (independent variable) on difference in QoL (dependent variable). Bivariable analyses (since age was always included in all models) were used to identify possible deteriorating subgroups exploring the previously mentioned baseline characteristics.…”

Impact of telephone follow-up and 24/7 hotline on 30-day readmission rates following aortic valve replacement -A randomized controlled trial

“…This readmission rate is higher than the pooled 30-DACR rate of 17%, as found in a recent meta-analysis [8]. However, the readmission rate in the present study is somewhat lower than that of an earlier study in our hospital (26%) [20]. Hospitals within and between countries vary on readmissions rates, and this is often attributed to differences in healthcare systems, policies, or hospital volumes, which evolve over time [21][22][23].…”