Comprehensive geriatric assessment in patients undergoing transcatheter aortic valve implantation - results from the CGA-TAVI multicentre registry.

Ungar, Andrea; Mannarino, Giulio; van der Velde, Nathalie; Baan, Jan; Thibodeau, Marie-Pierre; Masson, Jean-Bernard; Santoro, Gennaro; van Mourik, Martijn; Jansen, Sofie; Deutsch, Cornelia; Bramlage, Peter; Kurucova, Jana; Thoenes, Martin; Maggi, Stefania; Schoenenberger, Andreas W. (2018). Comprehensive geriatric assessment in patients undergoing transcatheter aortic valve implantation - results from the CGA-TAVI multicentre registry. BMC cardiovascular disorders, 18(1), p. 1. BioMed Central 10.1186/s12872-017-0740-x

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BACKGROUND In older patients with aortic stenosis (AS) undergoing TAVI, the potential role of prior CGA is not well established. To explore the value of comprehensive geriatric assessment (CGA) for predicting mortality and/or hospitalisation within the first 3 months after transcatheter aortic valve implantation (TAVI). METHODS An international, multi-centre, prospective registry (CGA-TAVI) was established to gather data on CGA results and medium-term outcomes in geriatric patients undergoing TAVI. Logistic regression was used to evaluate the predictive value of a multidimensional prognostic index (MPI); a short physical performance battery (SPPB); and the Silver Code, which was based on administrative data, for predicting death and/or hospitalisation in the first 3 months after TAVI (primary endpoint). RESULTS A total of 71 TAVI patients (mean age 85.4 years; mean log EuroSCORE I 22.5%) were enrolled. Device success according to VARC criteria was 100%. After adjustment for selected baseline characteristics, a higher (poorer) MPI score (OR: 3.34; 95% CI: 1.39-8.02; p = 0.0068) and a lower (poorer) SPPB score (OR: 1.15; 95% CI: 1.01-1.54; p = 0.0380) were found to be associated with an increased likelihood of the primary endpoint. The Silver Code did not show any predictive ability in this population. CONCLUSIONS Several aspects of the CGA have shown promise for being of use to physicians when predicting TAVI outcomes. While the MPI may be useful in clinical practice, the SPPB may be of particular value, being simple and quick to perform. Validation of these findings in a larger sample is warranted. TRIAL REGISTRATION The trial was registered in ClinicalTrials.gov on November 7, 2013 ( NCT01991444 ).

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of General Internal Medicine (DAIM) > Geriatric Clinic

UniBE Contributor:

Schoenenberger, Andreas

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1471-2261

Publisher:

BioMed Central

Language:

English

Submitter:

Rebecca Rufer

Date Deposited:

06 Sep 2019 15:15

Last Modified:

09 Sep 2019 18:16

Publisher DOI:

10.1186/s12872-017-0740-x

PubMed ID:

29301486

Uncontrolled Keywords:

Comprehensive geriatric assessment (CGA) Multidimensional prognostic index (MPI) Short physical performance battery (SPPB) Silver code Transcatheter aortic valve implantation (TAVI)

BORIS DOI:

10.7892/boris.126557

URI:

https://boris.unibe.ch/id/eprint/126557

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