The frailty syndrome and mortality among very old patients with symptomatic severe aortic stenosis under different treatments

Rodríguez-Pascual, Carlos; Paredes-Galán, Emilio; Ferrero-Martinez, A.I.; Baz-Alonso, José Antonio; Durán-Muñoz, Darío; González-Babarro, Eva; Sanmartín, Marcelo; Parajes, Teresa; Torres-Torres, Ivett; Piñón-Esteban, Miguel; Calvo-Iglesias, Francisco; Olcoz-Chiva, Maria Teresa; Rodríguez‐Artalejo, Fernando

doi:10.1016/j.ijcard.2016.09.020

Cited by 33 publications

(20 citation statements)

References 39 publications

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“…FFS [ 12 , 24 , 31 – 35 ] and scale modifications are widely used in studies involving VHD patients for frailty screening and unfavorable intervention/surgery outcome prediction. FFS was an accurate frailty assessment tool for prediction of increased hospitalization costs after cardiac surgery [ 31 ].…”

Section: Resultsmentioning

confidence: 99%

Frailty and Exercise Training: How to Provide Best Care after Cardiac Surgery or Intervention for Elder Patients with Valvular Heart Disease

Tamulevičiūtė-Prascienė

Drulyte

Jurenaite

et al. 2018

BioMed Research International

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The aim of this literature review was to evaluate existing evidence on exercise-based cardiac rehabilitation (CR) as a treatment option for elderly frail patients with valvular heart disease (VHD). Pubmed database was searched for articles between 1980 and January 2018. From 2623 articles screened, 61 on frailty and VHD and 12 on exercise-based training for patients with VHD were included in the analysis. We studied and described frailty assessment in this patient population. Studies reporting results of exercise training in patients after surgical/interventional VHD treatment were analyzed regarding contents and outcomes. The tools for frailty assessment included fried phenotype frailty index and its modifications, multidimensional geriatric assessment, clinical frailty scale, 5-meter walking test, serum albumin levels, and Katz index of activities of daily living. Frailty assessment in CR settings should be based on functional, objective tests and should have similar components as tools for risk assessment (mobility, muscle mass and strength, independence in daily living, cognitive functions, nutrition, and anxiety and depression evaluation). Participating in comprehensive exercise-based CR could improve short- and long-term outcomes (better quality of life, physical and functional capacity) in frail VHD patients. Such CR program should be led by cardiologist, and its content should include (1) exercise training (endurance and strength training to improve muscle mass, strength, balance, and coordination), (2) nutrition counseling, (3) occupational therapy (to improve independency and cognitive function), (4) psychological counseling to ensure psychosocial health, and (5) social worker counseling (to improve independency). Comprehensive CR could help to prevent, restore, and reduce the severity of frailty as well as to improve outcomes for frail VHD patients after surgery or intervention.

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Section: Resultsmentioning

confidence: 99%

Frailty and Exercise Training: How to Provide Best Care after Cardiac Surgery or Intervention for Elder Patients with Valvular Heart Disease

Tamulevičiūtė-Prascienė

Drulyte

Jurenaite

et al. 2018

BioMed Research International

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“…FS patients are older, more often female, have more co-morbidities and a higher perioperative risk. In addition, they have a lower New York Heart Association (NYHA) class, poorer kidney function, higher NTPproBNP (N-terminal pro-brain natriuretic peptide), more depressive symptoms, higher frequency of mobility restrictions in basic and complex everyday activities, and poorer results in quality of life studies (Rodríguez-Pascual et al, 2016). After over 4 years of observation, out of 54.4% of elderly patients without FS, but almost half of the patients suffered from pre-frail status (Chen, 2015).…”

Section: Epidemiologymentioning

confidence: 99%

Multidimensional Approach to Frailty

et al. 2020

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The concept of frailty syndrome (FS) was first described in the scientific literature three decades ago. For a very long time, we understood it as a geriatric problem, recently becoming one of the dominant concepts in cardiology. It identifies symptoms of FS in one in 10 elderly people. It is estimated that in Europe, 17% of elderly people have FS. The changes in FS resemble and often overlap with changes associated with the physiological aging process of the body. Although there are numerous scientific reports confirming that FS is age correlated, it is not an unavoidable part of the aging process and does not apply only to the elderly. FS is a reversible clinical condition. To maximize benefits of frailty-reversing activities for patient with frailty, identification of its determinants appears to be fundamental. Many of the determinants of the FS have already been known: reduction in physical activity, malnutrition, sarcopenia, polypharmacy, depressive symptom, cognitive disorders, and lack of social support. This review shows that insight into FS determinants is the starting point for building both the comprehensive definition of FS and the adoption of the assessment method of FS, and then successful clinical management.

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“…Nine studies [20,32,38,40,[49][50][51][52] (5876 patients) were included in the analysis for patients who were frail according to a frailty score. Different frailty scores were used among the studies such as the Canadian Study of Health and Aging Scale [49]; the PARTNER frailty definition (a composite of different markers: serum albumin, dominant hand grip strength, gait speed, Katz ADL survey) [40,50]; a cut-off on failing on three or more categories of the aforementioned PARTNER frailty markers, with the addition of BMI <20 kg/m 2 [32]; at least three of five criteria: muscle weakness, slow gait speed, low physical activity, exhaustion and unintentional weight loss [51]; Rockwood scale [52]; Clinical Frailty scale or a physician perceived frailty status based on clinical status and comorbidities, no strict frailty definition but more a physician-perceived frailty status based on clinical status and comorbidities [20,24,38].…”

Section: Frail According To Frailty Scorementioning

confidence: 99%

Preoperative frailty parameters as predictors for outcomes after transcatheter aortic valve implantation: a systematic review and meta-analysis

et al. 2020

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Guidelines suggest using frailty characteristics in the work-up for a transcatheter aortic valve implantation (TAVI). There are many frailty-screening tools with different components. The prognostic value of the individual parameters in frailty is as yet unclear. The objective of this systematic review and meta-analysis was to find and pool predictors for 1-year mortality after TAVI. We followed a twostep approach. First, we searched for randomised controlled trials on TAVI to identify frailty parameters used in these studies. Second, we searched for publications on these frailty parameters. Articles were included for pooled analysis if the studied frailty parameters were dichotomised with clear cutoff values based on common standards or clinical practice and reported adjusted hazard ratios (HR) of 1-year mortality after TAVI. We calculated pooled effect estimates of 49 studies based on dichotomised frailty scores (

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The frailty syndrome and mortality among very old patients with symptomatic severe aortic stenosis under different treatments

Cited by 33 publications

References 39 publications

Frailty and Exercise Training: How to Provide Best Care after Cardiac Surgery or Intervention for Elder Patients with Valvular Heart Disease

Frailty and Exercise Training: How to Provide Best Care after Cardiac Surgery or Intervention for Elder Patients with Valvular Heart Disease

Multidimensional Approach to Frailty

Preoperative frailty parameters as predictors for outcomes after transcatheter aortic valve implantation: a systematic review and meta-analysis

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