Highlights
- •The Erasmus Frailty score is associated with postoperative delirium and 1 year mortality.
- •The Erasmus Frailty score is associated with short and long term outcomes after TAVI.
- •Risk stratification can be improved by adding a frailty status to known clinical risk factors.
Abstract
Background
Frailty in patients undergoing Transcatheter Aortic Valve Implantation (TAVI) has
been associated with an increased 1-year mortality rate but the relation of frailty
and short term outcomes yields conflicting results. This study investigated the association
of a novel and self-developed Erasmus Frailty Score with both short and long term
outcomes after TAVI.
Methods
TAVI Care & Cure is an observational ongoing study, which includes consecutive patients
undergoing TAVI at the Erasmus University Medical Centre. Prior to the TAVI, frailty
status was assessed. The Erasmus Frailty Score (EFS) was defined as follows: 1 point
assigned if: MMSE was <27 points, MUST ≥2 points, grip strength <20 kg for females,
<30 kg for males, KATZ index ≥1 limited activity, Lawton and Brody index ≥2 limited
activity. The maximum score was 5. Patients were classified as frail when the score
was ≥3. Presence of delirium was evaluated by daily clinical assessment by a geriatrician
pre- and post-TAVI. Mortality data were obtained from the Dutch Civil Registry. The
impact of frailty on short and long term outcomes was evaluated.
Results
213 patients were included for analysis. Frailty was present in 28.6% (n = 61), (EFS ≥ 3). Baseline frailty was associated with patients developing a delirium
[OR 3.3 (95% CI 1,55–7,10), p = 0.002] and with increased risk of 1-year mortality [HR 2.1 (95% CI 1.01–4.52),
p = 0.047].
Conclusion
The Erasmus Frailty Score is associated with delirium and 1 year mortality in older
patients after TAVI and can be used as a complement to traditional risk factors.
Keywords
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Article info
Publication history
Published online: October 27, 2018
Accepted:
October 26,
2018
Received in revised form:
September 14,
2018
Received:
October 31,
2017
Identification
Copyright
© 2018 Published by Elsevier B.V.
