TY  - JOUR
A1  - Eichler, Sarah
A1  - Salzwedel, Annett
A1  - Harnath, Axel
A1  - Butter, Christian
A1  - Wegscheider, Karl
A1  - Chiorean, Mihai
A1  - Völler, Heinz
A1  - Reibis, Rona Katharina
T1  - Nutrition and mobility predict all-cause mortality in patients 12 months after transcatheter aortic valve implantation
JF  - Clinical research in cardiology : official journal of the German Cardiac Society.
N2  - The aim of the study was to determine pre-interventional predictors for all-cause mortality in patients after transcatheter aortic valve implantation (TAVI) with a 12-month follow-up. From 10/2013 to 07/2015, 344 patients (80.9 +/- 5.0 years, 44.5% male) with an elective TAVI were consecutively enrolled prospectively in a multicentre cohort study. Prior to the intervention, sociodemographic parameters, echocardiographic data and comorbidities were documented. All patients performed a 6-min walk test, Short Form 12 and a Frailty Index (score consisting of activities of daily living, cognition, nutrition and mobility). Peri-interventional complications were documented. Vital status was assessed over telephone 12 months after TAVI. Predictors for all-cause mortality were identified using a multivariate regression model. At discharge, 333 patients were alive (in-hospital mortality 3.2%; n = 11). During a follow-up of 381.0 +/- 41.9 days, 46 patients (13.8%) died. The non-survivors were older (82.3 +/- 5.0 vs. 80.6 +/- 5.1 years; p = 0.035), had a higher number of comorbidities (2.6 +/- 1.3 vs. 2.1 +/- 1.3; p = 0.026) and a lower left ventricular ejection fraction (51.0 +/- 13.6 vs. 54.6 +/- 10.6%; p = 0.048). Additionally, more suffered from diabetes mellitus (60.9 vs. 44.6%; p = 0.040). While the global Frailty Index had no predictive power, its individual components, particularly nutrition (OR 0.83 per 1 pt., CI 0.72-0.95; p = 0.006) and mobility (OR 5.12, CI 1.64-16.01; p = 0.005) had a prognostic impact. Likewise, diabetes mellitus (OR 2.18, CI 1.10-4.32; p = 0.026) and EuroSCORE (OR 1.21 per 5%, CI 1.07-1.36; p = 0.002) were associated with a higher risk of all-cause mortality. Besides EuroSCORE and diabetes mellitus, nutrition status and mobility of patients scheduled for TAVI offer prognostic information for 1-year all-cause mortality and should be advocated in the creation of contemporary TAVI risk scores.
KW  - TAVI
KW  - Frailty
KW  - Mortality
KW  - Malnutrition
KW  - Mobility
Y1  - 2018
U6  - https://doi.org/10.1007/s00392-017-1183-1
SN  - 1861-0684
SN  - 1861-0692
VL  - 107
IS  - 4
SP  - 304
EP  - 311
PB  - Springer
CY  - Heidelberg
ER  -