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Patel N, Teh W, Omoniyi O, Martin W, Weir-McCall J, D’Errico L, O’Sullivan M, Davies W, Costopoulos C, Costanzo P. 1069 ESSENTIAL FRAILTY TOOLSET AS A PREDICTOR OF PROLONGED LENGTH OF STAY AND DISCHARGE DESTINATION AFTER TRANSCATHETER AORTIC VALVE IMPLANTATION. Age Ageing 2022. [DOI: 10.1093/ageing/afac125.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
Frailty is associated with poor outcomes following transcatheter aortic valve implantation (TAVI). Rockwood is the widely used score for this population. In a recent trial, a more objective score, the Essential Frailty Toolset (EFT) outperformed Rockwood’s in predicting mortality and disability 1-year post-TAVI. Whether it predicts in-hospital length of stay (LOS) and discharge destination post-TAVI remains unclear.
Method
A cohort of patients undergoing TAVI for aortic stenosis was recruited, demographic characteristics collected, and frailty assessed with EFT and Rockwood scores. Primary outcomes were LOS post-TAVI, categorised as ‘not prolonged’ (≤2 days) or ‘prolonged’ (>2 days) and discharge destination, characterised as ‘home’ or ‘non-home’.
Results
86 patients were recruited, with median age 82 years (IQR 78–86). 54% were male. EFT identified 35% and Rockwood 11% as frail. 19% were cognitively impaired. 5 chair rises were completed by 70%, with 30% managing under 15 seconds. Median haemoglobin was 121 g/L (IQR 109.5–136). Median albumin was 36 g/L (IQR 33–39). 84% of procedures were transfemoral. 20% had moderate–severe left ventricular systolic dysfunction. Median LOS post-TAVI was 2 days (IQR 2–5). 94% were discharged home, 6% to referring local hospital or rehabilitation centre. 46% were NYHA class III-IV. A model for prolonged LOS including comorbidities, showed frailty determined by EFT (OR 4.80, CI 95% 1.52–15.2, p = 0.008) but not Rockwood (OR 5.00, CI 95% 0.865–29.0, p = 0.072) was the only significant independent predictor for prolonged LOS. A model adjusting for comorbidities also showed EFT to be an independent predictor for non-home discharge destination of borderline significance (OR 2.57 CI 95% 0.994–6.66, p = 0.051) but Rockwood was not (OR 1.38 CI95% 0.485–3.91, p = 0.548).
Conclusion
In a real-world elderly population, EFT score was a stronger, more independent predictor of prolonged LOS and non-home discharge post-TAVI, than Rockwood’s. EFT would be an effective pre-operative assessment tool for LOS and discharge destination for TAVI.
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Affiliation(s)
- N Patel
- Department of Interventional Cardiology and Radiology, Royal Papworth Hospital, Cambridge Biomedical Campus , UK
| | - W Teh
- Department of Interventional Cardiology and Radiology, Royal Papworth Hospital, Cambridge Biomedical Campus , UK
| | - O Omoniyi
- Department of Interventional Cardiology and Radiology, Royal Papworth Hospital, Cambridge Biomedical Campus , UK
| | - W Martin
- Department of Interventional Cardiology and Radiology, Royal Papworth Hospital, Cambridge Biomedical Campus , UK
| | - J Weir-McCall
- Department of Interventional Cardiology and Radiology, Royal Papworth Hospital, Cambridge Biomedical Campus , UK
| | - L D’Errico
- Department of Interventional Cardiology and Radiology, Royal Papworth Hospital, Cambridge Biomedical Campus , UK
| | - M O’Sullivan
- Department of Interventional Cardiology and Radiology, Royal Papworth Hospital, Cambridge Biomedical Campus , UK
| | - W Davies
- Department of Interventional Cardiology and Radiology, Royal Papworth Hospital, Cambridge Biomedical Campus , UK
| | - C Costopoulos
- Department of Interventional Cardiology and Radiology, Royal Papworth Hospital, Cambridge Biomedical Campus , UK
| | - P Costanzo
- Department of Interventional Cardiology and Radiology, Royal Papworth Hospital, Cambridge Biomedical Campus , UK
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Audisio G, D’Errico L, Pasino C, Orsogiacone G. OSSERVAZIONI SULL’USO DI PRODOTTI PER L’IGIENE INTIMA FEMMINILE. Microbiol Med 2004. [DOI: 10.4081/mm.2004.4031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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