Evaluation of Changes in Functional Status in the Year After Aortic Valve Replacement
|How does functional status change in the year after transcatheter and surgical aortic valve replacement?|
|Findings In this cohort study of 246 elderly patients (mean age, 78.1 years), the proportions of patients who had excellent, good, fair, poor, and very poor functional trajectories were 14.0%, 23.1%, 37.9%, 14.7%, and 8.4%, respectively, after transcatheter aortic valve replacement, and 36.9%, 37.9%, 19.4%, 2.9%, and 1.0%, respectively, after surgical aortic valve replacement. Preoperative frailty level as well as major complications and delirium were associated with functional decline or lack of improvement.
Meaning Despite disease-specific benefits of aortic valve replacement, functional decline or lack of functional improvement is common in older patients with severe frailty; information on functional trajectories may be useful for patient-centered decision making and perioperative care to optimize functional outcomes.
|Kim DH, Afilalo J, Shi SM, et al.||JAMA Intern Med. 2019;179(3):383-391. doi:10.1001/jamainternmed.2018.6738|
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