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The journal of nutrition health & aging
Article . 2017 . Peer-reviewed
License: CC BY NC ND
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Predictors of health-related quality of life decline after transcatheter aortic valve replacement in older patients with severe aortic stenosis

Authors: Boureau, Anne Sophie; Trochu, J.; Rouaud, A.; Hureau, R.; Jaafar, P.; Manigold, T.; Letocart, V.; +3 Authors

Predictors of health-related quality of life decline after transcatheter aortic valve replacement in older patients with severe aortic stenosis

Abstract

Transcatheter aortic-valve implantation (TAVI) has been shown to improve survival and quality of life in patients with severe aortic stenosis. However, one-third of patients have poor outcome as death, functional decline or quality of life (QoL) decline. The aim of this study was to determine cardiac and geriatric predictors of physical and mental QoL decline 6 months after a TAVI procedure in patients aged 75 and older.Between January 2013 and June 2014, we did a prospective and multicenter study including patients ≥ 75 years old referred for TAVI. The primary outcome was the measure of QoL, assessed by the Short Form 36 survey (SF-36), before and 6 months after the intervention. Association between QoL decline and baseline characteristics including cardiac and geriatric factors was analysed by logistic regression models.Mean age of the 150 patients studied was 83.7 years old and 56% were men. The primary end point, mean SF-36 physical summary score, significantly improved between baseline and 6-month (33.6 vs. 36.4, p=0.003) whereas mental component score significantly decreased (48.2 vs. 36.4, p-value<0.001). However, patients with presence of depressive symptoms before the intervention had mental QoL improvement at six months (OR 0.04 [0.01-0.19], p-value<0.001) and no significant geriatric predictors were associated with physical QoL decline.The mental QoL significantly decreased and patients with preoperative depressive symptoms had mental QoL improvement at six months. Researches are needed to confirm that mental QoL of patients with depressive symptoms can be improved by TAVI.

Keywords

Male, geriatric assessment, [SDV]Life Sciences [q-bio], aortic valve stenosis, Transcatheter Aortic Valve Replacement, Surveys and Questionnaires, Older patients, MESH: Aged Aged, Humans, Prospective Studies, Geriatric Assessment, Aged, Aged, 80 and over, Depression, Aortic Valve Stenosis, health-related quality of life, Logistic Models, Treatment Outcome, Quality of Life, Female, 80 and over Aortic Valve Stenosis / surgery* Depression / prevention & control Female Follow-Up Studies Geriatric Assessment Humans Logistic Models Male Prospective Studies Quality of Life* Surveys and Questionnaires Transcatheter Aortic Valve Replacement* Treatment Outcome, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Follow-Up Studies

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    20
    popularity
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    Top 10%
    influence
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    impulse
    This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
    Average
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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
20
Top 10%
Average
Average
gold