IMPACT OF FRAILTY ON CLINICAL OUTCOMES IN ELDERLY AFTER TRANSCATHETER AORTIC VALVE REPLACEMENT
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Abstract
Background: Transcatheter aortic valve replacement is a safer alternative to valve replacement surgery and has become a popular treatment in aortic stenosis. Elderly patients with frailty who receive transcatheter aortic valve replacement may not change prognosis, even have worse outcomes and higher mortality than non-frail patients. Objective: Identify the impact of frailty on clinical outcomes in elderly patients after transcatheter aortic valve replacement at Vinmec Central Park Hospital. Methods: The study was conducted from January 2017 to May 2022, in elderly patients with symptomatic aortic stenosis undergoing transcatheter aortic valve replacement. Assessment of frailty using the following indices: albumin level, anemia and Katz index of independence in Activities of Daily Living. The composite clinical endpoint included all outcomes occurring 1 month, 6 months, and 12 months after transcatheter aortic valve replacement. Testing the relationship between frailty and overall clinical outcome by logistic regression, the difference was statistically significant with p<0.05. Results: The study enrolled 73 elderly patients, with a median age of 69 (62–76). Composite clinical outcome (procedure failure, vascular complications, major bleeding, stroke, acute kidney injury, pacemaker placement and mortality) at 1 month, 6 months, and 12 months, respectively, accounted for 34.25%, 36.99% and 38.36%. Patients with 3 abnormal frailty indices had an increased ability of adverse clinical outcomes at 1 month, 6 months, and 12 months (p = 0.030, p = 0.036 and p = 0.024, respectively). Conclusions: Preliminary findings suggest that elderly patients with impairment in activities of daily living, low albumin levels, and anemia are associated with an increased ability of 1-month, 6-month, and 12-month clinical outcomes after transcatheter aortic valve replacement
Keywords
transcatheter aortic valve replacement, frailty, elderly, outcome.
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References
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