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Geriatric or cardiac rehabilitation?

  • Background Aim of the study was to find predictors of allocating patients after transcatheter aortic valve implantation (TAVI) to geriatric (GR) or cardiac rehabilitation (CR) and describe this new patient group based on a differentiated characterization. Methods From 10/2013 to 07/2015, 344 patients with an elective TAVI were consecutively enrolled in this prospective multicentric cohort study. Before intervention, sociodemographic parameters, echocardiographic data, comorbidities, 6-min walk distance (6MWD), quality of life and frailty (score indexing activities of daily living [ADL], cognition, nutrition and mobility) were documented. Out of these, predictors for assignment to CR or GR after TAVI were identified using a multivariable regression model. Results After TAVI, 249 patients (80.7 ± 5.1 years, 59.0% female) underwent CR (n = 198) or GR (n = 51). GR patients were older, less physically active and more often had a level of care, peripheral artery disease as well as a lower left ventricular ejection fraction.Background Aim of the study was to find predictors of allocating patients after transcatheter aortic valve implantation (TAVI) to geriatric (GR) or cardiac rehabilitation (CR) and describe this new patient group based on a differentiated characterization. Methods From 10/2013 to 07/2015, 344 patients with an elective TAVI were consecutively enrolled in this prospective multicentric cohort study. Before intervention, sociodemographic parameters, echocardiographic data, comorbidities, 6-min walk distance (6MWD), quality of life and frailty (score indexing activities of daily living [ADL], cognition, nutrition and mobility) were documented. Out of these, predictors for assignment to CR or GR after TAVI were identified using a multivariable regression model. Results After TAVI, 249 patients (80.7 ± 5.1 years, 59.0% female) underwent CR (n = 198) or GR (n = 51). GR patients were older, less physically active and more often had a level of care, peripheral artery disease as well as a lower left ventricular ejection fraction. The groups also varied in 6MWD. Furthermore, individual components of frailty revealed prognostic impact: higher values in instrumental ADL reduced the probability for referral to GR (OR:0.49, p <  0.001), while an impaired mobility was positively associated with referral to GR (OR:3.97, p = 0.046). Clinical parameters like stroke (OR:0.19 of GR, p = 0.038) and the EuroSCORE (OR:1.04 of GR, p = 0.026) were also predictive. Conclusion Advanced age patients after TAVI referred to CR or GR differ in several parameters and seem to be different patient groups with specific needs, e.g. regarding activities of daily living and mobility. Thus, our data prove the eligibility of both CR and GR settings.zeige mehrzeige weniger

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Metadaten
Verfasserangaben:Sarah EichlerORCiDGND, Heinz VöllerORCiDGND, Rona Katharina ReibisORCiDGND, Karl WegscheiderORCiDGND, Christian Butter, Axel Harnath, Annett SalzwedelORCiDGND
DOI:https://doi.org/10.1186/s12872-020-01452-x
ISSN:1471-2261
Titel des übergeordneten Werks (Englisch):BMC Cardiovascular Disorders
Untertitel (Englisch):Predictors of treatment pathways in advanced age patients after transcatheter aortic valve implantation
Verlag:BioMed Central
Verlagsort:London
Publikationstyp:Wissenschaftlicher Artikel
Sprache:Englisch
Datum der Erstveröffentlichung:01.08.2019
Erscheinungsjahr:2020
Datum der Freischaltung:04.08.2020
Freies Schlagwort / Tag:Frailty; Geriatric rehabilitation; TAVI; Treatment pathways
Band:20
Seitenanzahl:9
Fördernde Institution:Universität Potsdam
Fördernummer:2020_041
Organisationseinheiten:Humanwissenschaftliche Fakultät / Strukturbereich Kognitionswissenschaften
DDC-Klassifikation:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Peer Review:Referiert
Fördermittelquelle:Publikationsfonds der Universität Potsdam
Publikationsweg:Open Access / Gold Open-Access
Lizenz (Deutsch):License LogoCC-BY - Namensnennung 4.0 International
Lizenz (Deutsch):License LogoCreative Commons - CC0 1.0 - Universell - Public Domain Dedication
Externe Anmerkung:Zweitveröffentlichung in der Schriftenreihe Postprints der Universität Potsdam : Humanwissenschaftliche Reihe ; 647
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