Predictors of functional decline in elderly patients undergoing transcatheter aortic valve implantation (TAVI)
Citations
817 citations
Cites background or result from "Predictors of functional decline in..."
...This is in slight contrast to the TAVR experience at Bern University (73,74), in which the vast majority of patients were able to complete the timed-up-and-go test (which requires standing up from a chair, walking 3 m, and turning around) and 61% of patients were able to do so faster than the usual cutoff of 20 s....
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...Schoenenberger, 2012 (73) 119 Prospective cohort of patients undergoing TAVR In-house scale 3/7 50% 6-month ADL change 1: 31....
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605 citations
Additional excerpts
...Functional Decline Quality [ref] Q1 [20] Q2 [28]...
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532 citations
509 citations
Cites background from "Predictors of functional decline in..."
...Lower-extremity muscle weakness, malnutrition, and cognitive impairment played a prominent role in newer scales, which were shown in small studies of 100 to 244 patients to have a predictive effect on mortality and disability 6 to 12 months after TAVR (18,19,33)....
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...SAVR isolated 179 (18) 173 (20) 6 (4) SAVR with bypass 195 (19) 175 (20) 20 (14)...
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...The Bern scale consists of 6 items for a composite score of 0 to 7: gait speed, mobility, cognition, nutrition, ADL and IADL disability (17,18)....
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...002 Cognitive impairment† 179 (18) 125 (14) 54 (37) <0....
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...08 Weight loss 179 (18) 146 (17) 33 (23) 0....
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301 citations
Cites background or methods or result from "Predictors of functional decline in..."
...In the studies investigating TAVR and frailty, patients were older and had increased EuroSCOREs, which may account for the increase in the hazard ratios and ORs.(15,16) Patients who are undergoing TAVR are typically selected with the notion that they would not fair well with a conventional surgical aortic valve replacement....
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...Two studies(14,15) used a modified geriatric baseline examination, whereas another looked at the Katz Index of Independence in Activities of Daily Living, independence in ambulation, and previous diagnosis of dementia.(16) Afilalo and colleagues(2) looked at 4 scales for comparison....
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...3112 The Journal of Thoracic and Cardiovascular Sur Multidimensional Geriatric Assessment for determining frailty.(15,16) Both studies had parallel results, with 1 study(15) finding a significant association between frailty and functional decline (OR, 4....
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...However transcatheter aortic valve implantation is used to treat severe aortic stenosis and is reserved for older patients who are deemed inoperable.15 In the studies investigating TAVR and frailty, patients were older and had increased EuroSCOREs, which may account for the increase in the hazard ratios and ORs.15,16 Patients who are undergoing TAVR are typically selected with the notion that they would not fair well with a conventional surgical aortic valve replacement.3 This could lead to a discrepancy when trying to apply the studies findings to those in a lower risk demographic.3...
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References
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"Predictors of functional decline in..." refers background or methods in this paper
...The advantage of this operational definition of frailty is the inclusion of cognitive function, an aspect not covered in other operational definitions of frailty.(27) However, prior to clinical use, additional research is needed to confirm the validity of this newly proposed index....
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...Fifthly, frailty is a novel concept in geriatrics, and there is not yet a generally accepted operational definition of frailty in the literature.(27,28) In the present study, frailty was defined as an index based on validated instruments covering key subdomains related to frailty and disability in old age....
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...According to existing literature, cognition, mobility, and nutritional status are the most commonly used components of frailty.(27,28) The frailty index of the present study was calculated as summary score from the following baseline components: 2 points were assigned, if MMSE was ,21 points; 1 point was assigned for each of the following: MMSE ≥ 21 and ,27 points, TUG ≥ 20 s, MNA , 12 points, BADL ≥ 1 limited activity, IADL ≥ 1 limited activity, and a pre-clinical mobility disability (defined as decreased frequency of walking 200 m and/or of climbing stairs during the preceding 6 months)....
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