E Calvo, P Castillo, R Romaguera, I Llaó, R Zafrilla, G Domene, O Alegre, V Lorente, G Muntané-Carol, F Formiga, Fj de la Cuerda, Ja Gomez Hospital, A Ariza-Solè
Department of Cardiology, Bellvitge University Hospital, Spain.
Faculty of nursing, University of Barcelona, Spain.
J Geriatr Cardiol. 2025 May 28;22(5):516-524. doi: 10.26599/1671-5411.2025.05.005.
There is scarce data about comparisons between geriatric assessment tools in patients with aortic stenosis (AS). We aimed to describe the geriatric profile of patients with AS undergoing transcatheter aortic valve implantation (TAVI) and to analyze the ability of different tools for predicting clinical outcomes in this context.
This was a single center retrospective registry including patients with AS undergoing TAVI and surviving to hospital discharge. The primary endpoint was all-cause mortality or need for urgent readmission one year after TAVI.
A total of 377 patients were included (mean age of 80.4 years). Most patients were independent or mildly dependent, with an optimal cognitive status. The proportion of frailty ranged from 17.6% to 49.8%. A total of 20 patients (5.3%) died and 110/377 patients (29.2%) died or were readmitted during follow up. Overall, most components of the geriatric assessment showed an association with clinical outcomes. Disability for instrumental activities showed a significant association with mortality and a strong association with the rate of mortality or readmission. The association between frailty and clinical outcomes was higher for short physical performance battery (SPPB), essential frailty toolset (EFT) and the frailty index based on comprehensive geriatric assessment (IF-VIG) and lower for Fried criteria and FRAIL scale.
AS patients from this series presented a good physical performance, optimal cognitive status and a reasonably low prevalence of frailty. The best predictive ability was observed for disability for instrumental activities and frailty as measured by the EFT, SPPB and the IF-VIG.
关于主动脉瓣狭窄（AS）患者老年评估工具之间比较的数据稀缺。我们旨在描述接受经导管主动脉瓣植入术（TAVI）的AS患者的老年特征，并分析不同工具在此背景下预测临床结局的能力。
这是一项单中心回顾性登记研究，纳入接受TAVI且存活至出院的AS患者。主要终点是TAVI术后一年的全因死亡率或紧急再入院需求。
共纳入377例患者（平均年龄80.4岁）。大多数患者独立或轻度依赖，认知状态良好。虚弱比例在17.6%至49.8%之间。共有20例患者（5.3%）死亡，110/377例患者（29.2%）在随访期间死亡或再入院。总体而言，老年评估的大多数组成部分与临床结局相关。工具性日常生活活动能力障碍与死亡率显著相关，与死亡率或再入院率密切相关。对于短身体功能测试（SPPB）、基本虚弱工具集（EFT）和基于综合老年评估的虚弱指数（IF-VIG），虚弱与临床结局之间的关联较高，而对于弗里德标准和衰弱量表则较低。
本系列中的AS患者身体功能良好，认知状态最佳，虚弱患病率相对较低。对于工具性日常生活活动能力障碍和通过EFT、SPPB和IF-VIG测量的虚弱，观察到最佳预测能力。
