Impact of Frailty Markers for Unplanned Hospital Readmission Following Transcatheter Aortic Valve Implantation.

Abstract

BACKGROUND:

Various frailty markers have been developed to guide better patient selection for transcatheter aortic valve implantation (TAVI). This study aimed to investigate the frequency and specific causes of unplanned hospital readmission after TAVI, and to investigate which frailty markers better predicted outcomes.Methods and Results:We retrospectively reviewed 155 patients for whom we calculated their Short Physical-Performance Battery (SPPB), Placement of AoRTic TraNscathetER Valve (PARTNER) frailty scale, frailty index, clinical frailty scale, modified Fried scale, and gait speed. The primary endpoint was unplanned readmission following TAVI. The clinical model was established using variables that were identified as independent predictors in multivariate analysis. Incremental values were assessed after adding each frailty marker to the clinical model, and were compared between frailty markers. Although unplanned readmission <30 days was 1.9%, 23% of patients had an unplanned readmission following TAVI mainly because of heart failure and pneumonia within 1 year. Frailty markers other than the modified Fried scale were independently associated with unplanned readmission. The SPPB and the PARTNER frailty scale significantly increased discriminatory performance for predicting unplanned readmission.

CONCLUSIONS:

Unplanned readmissions following TAVI in the present study were fewer than previously reported. There seems to be a difference between frailty markers in their predictive performance. Precise frailty assessment may result in reducing unplanned admissions after TAVI and therefore better quality of life.

• Authors: Mike Saji, Ryosuke Higuchi, Tetsuya Tobaru, Nobuo Iguchi, Shuichiro Takanashi, Morimasa Takayama, Mitsuaki Isobe
• Journal: Circulation journal : official journal of the Japanese Circulation Society (Circ J) Vol. 82 Issue 8 Pg. 2191-2198 (07 25 2018) ISSN: 1347-4820 [Electronic] Japan
• PMID: 29311518 (Publication Type: Journal Article)

Chemical References

• Biomarkers

Topics

• Aged
• Aged, 80 and over
• Biomarkers (analysis)
• Female
• Frailty (diagnosis)
• Heart Failure (etiology)
• Humans
• Male
• Patient Readmission
• Pneumonia (etiology)
• Retrospective Studies
• Risk Assessment
• Transcatheter Aortic Valve Replacement (adverse effects, trends)