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BMC Cardiovascular Disorders
Published in: BMC Cardiovascular Disorders 1/2018

Open Access 01-12-2018 | Research article

Comprehensive geriatric assessment in patients undergoing transcatheter aortic valve implantation – results from the CGA-TAVI multicentre registry

Authors: Andrea Ungar, Giulio Mannarino, Nathalie van der Velde, Jan Baan, Marie-Pierre Thibodeau, Jean-Bernard Masson, Gennaro Santoro, Martijn van Mourik, Sofie Jansen, Cornelia Deutsch, Peter Bramlage, Jana Kurucova, Martin Thoenes, Stefania Maggi, Andreas W. Schoenenberger

Published in: BMC Cardiovascular Disorders | Issue 1/2018

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Abstract

Background

In older patients with aortic stenosis (AS) undergoing TAVI, the potential role of prior CGA is not well established. To explore the value of comprehensive geriatric assessment (CGA) for predicting mortality and/or hospitalisation within the first 3 months after transcatheter aortic valve implantation (TAVI).

Methods

An international, multi-centre, prospective registry (CGA-TAVI) was established to gather data on CGA results and medium-term outcomes in geriatric patients undergoing TAVI. Logistic regression was used to evaluate the predictive value of a multidimensional prognostic index (MPI); a short physical performance battery (SPPB); and the Silver Code, which was based on administrative data, for predicting death and/or hospitalisation in the first 3 months after TAVI (primary endpoint).

Results

A total of 71 TAVI patients (mean age 85.4 years; mean log EuroSCORE I 22.5%) were enrolled. Device success according to VARC criteria was 100%. After adjustment for selected baseline characteristics, a higher (poorer) MPI score (OR: 3.34; 95% CI: 1.39–8.02; p = 0.0068) and a lower (poorer) SPPB score (OR: 1.15; 95% CI: 1.01–1.54; p = 0.0380) were found to be associated with an increased likelihood of the primary endpoint. The Silver Code did not show any predictive ability in this population.

Conclusions

Several aspects of the CGA have shown promise for being of use to physicians when predicting TAVI outcomes. While the MPI may be useful in clinical practice, the SPPB may be of particular value, being simple and quick to perform. Validation of these findings in a larger sample is warranted.

Trial registration

The trial was registered in ClinicalTrials.gov on November 7, 2013 (NCT01991444).
Appendix
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Metadata
Title
Comprehensive geriatric assessment in patients undergoing transcatheter aortic valve implantation – results from the CGA-TAVI multicentre registry
Authors
Andrea Ungar
Giulio Mannarino
Nathalie van der Velde
Jan Baan
Marie-Pierre Thibodeau
Jean-Bernard Masson
Gennaro Santoro
Martijn van Mourik
Sofie Jansen
Cornelia Deutsch
Peter Bramlage
Jana Kurucova
Martin Thoenes
Stefania Maggi
Andreas W. Schoenenberger
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Cardiovascular Disorders / Issue 1/2018
Electronic ISSN: 1471-2261
DOI
https://doi.org/10.1186/s12872-017-0740-x

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