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Frailty, periinterventional complications and outcome in patients undergoing percutaneous mitral and tricuspid valve repair.
Schäfer, Matthieu; Nöth, Hannah; Metze, Clemens; Iliadis, Christos; Körber, Maria Isabel; Halbach, Marcel; Baldus, Stephan; Pfister, Roman.
Afiliación
  • Schäfer M; University of Cologne, Faculty of Medicine and University Hospital Cologne, Clinic III for Internal Medicine, Köln, Germany. matthieu.schaefer@uk-koeln.de.
  • Nöth H; University of Cologne, Faculty of Medicine and University Hospital Cologne, Clinic III for Internal Medicine, Köln, Germany.
  • Metze C; University of Cologne, Faculty of Medicine and University Hospital Cologne, Clinic III for Internal Medicine, Köln, Germany.
  • Iliadis C; University of Cologne, Faculty of Medicine and University Hospital Cologne, Clinic III for Internal Medicine, Köln, Germany.
  • Körber MI; University of Cologne, Faculty of Medicine and University Hospital Cologne, Clinic III for Internal Medicine, Köln, Germany.
  • Halbach M; University of Cologne, Faculty of Medicine and University Hospital Cologne, Clinic III for Internal Medicine, Köln, Germany.
  • Baldus S; University of Cologne, Faculty of Medicine and University Hospital Cologne, Clinic III for Internal Medicine, Köln, Germany.
  • Pfister R; University of Cologne, Faculty of Medicine and University Hospital Cologne, Clinic III for Internal Medicine, Köln, Germany.
Clin Res Cardiol ; 2024 Feb 15.
Article en En | MEDLINE | ID: mdl-38358418
ABSTRACT

BACKGROUND:

Frailty is common in elderly and multimorbid patients and associated with increased vulnerability to stressors.

METHODS:

In a single centre study frailty according to Fried criteria was assessed in consecutive patients before transcatheter mitral and tricuspid valve repair. Postprocedural infections, blood transfusion and bleeding and renal failure were retrospectively assessed from records. Median follow-up time for survival was 560 days (IQR 363 to 730 days).

RESULTS:

90% of 626 patients underwent mitral valve repair, 5% tricuspid valve repair, and 5% simultaneous mitral and tricuspid valve repair. 47% were classified as frail. Frailty was associated with a significantly increased frequency of bleeding (16 vs 10%; p = 0.016), blood transfusions (9 vs 3%; p = < 0.001) and infections (18 vs 10%; p = 0.006), but not with acute kidney injury (20 vs 20%; p = 1.00). Bleeding and infections were associated with longer hospital stays, with a more pronounced effect in frail patients (interaction test p < 0.05, additional 3.2 and 4.1 days in frail patients, respectively). Adjustment for the occurrence of complications did not attenuate the increased risk of mortality associated with frailty (HR 2.24 [95% CI 1.62-3.10]; p < 0.001).

CONCLUSIONS:

Bleeding complications and infections were more frequent in frail patients undergoing transcatheter mitral and tricuspid valve repair and partly explained the longer hospital stay. Albeit some of the complications were associated with higher long-term mortality, this did not explain the strong association between frailty and mortality. Further research is warranted to explore interventions targeting periprocedural complications to improve outcomes in this vulnerable population.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Clin Res Cardiol Asunto de la revista: CARDIOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Alemania Pais de publicación: Alemania
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Clin Res Cardiol Asunto de la revista: CARDIOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Alemania Pais de publicación: Alemania