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A practical two-stage frailty assessment for older adults undergoing aortic valve replacement

Journal of the American Geriatrics Society Oct 25, 2019

Hosler QP, Maltagliati AJ, Shi SM, et al. - In this prospective cohort study performed at a single academic center, researchers assessed the relative abilities of five brief frailty tests for foretelling poor outcomes post-aortic valve replacement, and they evaluated the outcomes of a strategy of performing comprehensive geriatric assessment (CGA) in screen-positive patients. This study included 91 patients undergoing surgical aortic valve replacement (SAVR) (mean age = 77.8 y) or 137 with mean age 84.5 y who were receiving transcatheter aortic valve replacement (TAVR) between February 2014 and June 2017. At baseline, the participants were examined via brief frailty tests (Fatigue, Resistance, Ambulation, Illness, and Loss of weight scale; Clinical Frailty Scale; grip strength; gait speed; and chair rise) and a deficit-accumulation frailty index depending on CGA. At 6 months, an evaluation was made for a composite of death or functional decline and severe symptoms. The occurrence of the outcome was reported in 8.8% (n = 8) post-SAVR and 24.8% (n = 34) post-TAVR. Based on the findings, experts viewed chair rise test with targeted CGA as a possible practical strategy that can afford identification of older patients who have a high risk for death and poor recovery following SAVR and TAVR and in whom individualized care management should be considered.
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