Hinterbuchner Lynne, Strohmer Bernhard, Hammerer Matthias, Prinz Erika, Hoppe Uta C, Schernthaner Christiana
Department of Cardiology, Paracelsus Medical University, Salzburger Landeskliniken, Salzburg, Austria.
Department of Cardiology, Paracelsus Medical University, Salzburger Landeskliniken, Salzburg, Austria
Eur J Cardiovasc Nurs. 2016 Oct;15(6):384-97. doi: 10.1177/1474515115596640. Epub 2015 Jul 27.
Transcatheter aortic valve replacement (TAVR) is a less invasive treatment option for patients that are deemed too high a risk for surgical aortic valve replacement (SAVR). The aim of this review is to evaluate the frailty tools currently being used in patients referred for TAVR.
Using a literature search involving database search engines from CINAHL, PubMed, SAGE publications and European Society of Cardiology conducted from 2010 to the present, a critical evaluation of studies dealing with frailty assessment in patients referred for TAVR/SAVR is discussed.
Eight studies met the criteria using frailty assessment in TAVR/SAVR patients. In all reviewed studies the impact of frailty on clinical outcome has been proved. Different instruments for measurements of frailty were used that have not been robustly evaluated. Frailty was defined differently and results may not be comparable. All reviewed studies used different cutoffs and scales and some a composite scoring system, although validity was limited.
For frailty assessment implementation of validated standardized test protocols based on well-established assessment tools, covering all domains of frailty among TAVR centers is crucial for patient selection. Secondly, validated cutoffs and scoring systems are essential.
经导管主动脉瓣置换术（TAVR）是一种侵入性较小的治疗选择，适用于那些被认为进行外科主动脉瓣置换术（SAVR）风险过高的患者。本综述的目的是评估目前在接受TAVR治疗的患者中使用的虚弱评估工具。
通过对2010年至今从CINAHL、PubMed、SAGE出版物和欧洲心脏病学会的数据库搜索引擎进行文献检索，讨论了对接受TAVR/SAVR治疗的患者进行虚弱评估的研究的批判性评价。
八项研究符合在TAVR/SAVR患者中使用虚弱评估的标准。在所有综述研究中，虚弱对临床结局的影响已得到证实。使用了不同的虚弱测量工具，但尚未进行充分评估。虚弱的定义不同，结果可能无法比较。所有综述研究都使用了不同的临界值和量表，有些使用了综合评分系统，尽管有效性有限。
对于虚弱评估，基于成熟评估工具实施经过验证的标准化测试方案，涵盖TAVR中心虚弱的所有领域，对于患者选择至关重要。其次，经过验证的临界值和评分系统至关重要。
