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Clin Res Cardiol. 2018 Apr;107(4):304-311. doi: 10.1007/s00392-017-1183-1. Epub 2017 Nov 21.

Nutrition and mobility predict all-cause mortality in patients 12 months after transcatheter aortic valve implantation.

Author information

1
Center of Rehabilitation Research, University of Potsdam, Am Neuen Palais 10, House 12, 14469, Potsdam, Germany.
2
Sana Heart-Center Cottbus, Cottbus, Germany.
3
Heart Center Brandenburg in Bernau/Berlin and Brandenburg Medical School, Bernau, Germany.
4
Department of Medical Biometry and Epidemiology, University Medical Center, Hamburg-Eppendorf, Hamburg, Germany.
5
Klinik am See, Rehabilitation Center for Internal Medicine, Rüdersdorf, Germany.
6
Center of Rehabilitation Research, University of Potsdam, Am Neuen Palais 10, House 12, 14469, Potsdam, Germany. heinz.voeller@uni-potsdam.de.
7
Klinik am See, Rehabilitation Center for Internal Medicine, Rüdersdorf, Germany. heinz.voeller@uni-potsdam.de.
8
Cardiological Outpatient Clinic Am Park Sanssouci, Potsdam, Germany.

Abstract

BACKGROUND:

The aim of the study was to determine pre-interventional predictors for all-cause mortality in patients after transcatheter aortic valve implantation (TAVI) with a 12-month follow-up.

METHODS:

From 10/2013 to 07/2015, 344 patients (80.9 ± 5.0 years, 44.5% male) with an elective TAVI were consecutively enrolled prospectively in a multicentre cohort study. Prior to the intervention, sociodemographic parameters, echocardiographic data and comorbidities were documented. All patients performed a 6-min walk test, Short Form 12 and a Frailty Index (score consisting of activities of daily living, cognition, nutrition and mobility). Peri-interventional complications were documented. Vital status was assessed over telephone 12 months after TAVI. Predictors for all-cause mortality were identified using a multivariate regression model.

RESULTS:

At discharge, 333 patients were alive (in-hospital mortality 3.2%; n = 11). During a follow-up of 381.0 ± 41.9 days, 46 patients (13.8%) died. The non-survivors were older (82.3 ± 5.0 vs. 80.6 ± 5.1 years; p = 0.035), had a higher number of comorbidities (2.6 ± 1.3 vs. 2.1 ± 1.3; p = 0.026) and a lower left ventricular ejection fraction (51.0 ± 13.6 vs. 54.6 ± 10.6%; p = 0.048). Additionally, more suffered from diabetes mellitus (60.9 vs. 44.6%; p = 0.040). While the global Frailty Index had no predictive power, its individual components, particularly nutrition (OR 0.83 per 1 pt., CI 0.72-0.95; p = 0.006) and mobility (OR 5.12, CI 1.64-16.01; p = 0.005) had a prognostic impact. Likewise, diabetes mellitus (OR 2.18, CI 1.10-4.32; p = 0.026) and EuroSCORE (OR 1.21 per 5%, CI 1.07-1.36; p = 0.002) were associated with a higher risk of all-cause mortality.

CONCLUSIONS:

Besides EuroSCORE and diabetes mellitus, nutrition status and mobility of patients scheduled for TAVI offer prognostic information for 1-year all-cause mortality and should be advocated in the creation of contemporary TAVI risk scores.

KEYWORDS:

Frailty; Malnutrition; Mobility; Mortality; TAVI

PMID:
29164390
PMCID:
PMC5869890
DOI:
10.1007/s00392-017-1183-1
[Indexed for MEDLINE]
Free PMC Article

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