The Impact of Frailty on Patient-Centered Outcomes Following Aortic Valve Replacement

Brian R. Kotajarvi, Marissa J. Schafer, Elizabeth J. Atkinson, Megan M. Traynor, Charles J Bruce, Kevin L. Greason, Rakesh M. Suri, Jordan D Miller, Nathan K LeBrasseur

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13 Scopus citations

Abstract

Background: Frailty confers risk for surgical morbidity and mortality. Whether patient-reported measures of health, well-being, or quality of life respond differently to surgery in non-frail and frail individuals is unknown. Methods: Older adults with severe aortic stenosis presenting for surgery were assessed for frailty using Cardiovascular Health Study Criteria. Patient-reported measures of functional capacity (Duke Activity Status Index [DASI]), physical and mental health (Medical Outcomes Study Short Form-Physical and Mental Component Scales [SF-12 PCS and SF-12 MCS, respectively]), well-being (linear analogue self-assessment [LASA]), and quality of life (LASA) were administered before and 3 months after surgery. Results: Of 103 participants (mean age of 80.6 years), 54 were frail. Frail participants had lower baseline DASI, SF-12 PCS, SF-12 MCS, physical well-being, and quality of life scores than non-frail participants. At follow-up, frail participants showed significant improvement in physical function, with DASI and SF-12 PCS scores improving by 50% and 14%, respectively. Non-frail subjects did not significantly improve in these measures. SF-12 MCS scores also improved to a greater extent in frail compared to non-frail participants (3.6 vs < 1 point). Furthermore, the frail participants improved to a greater extent than non-frail participants in physical well-being (21.6 vs 7.1 points) and quality of life measures (25.1 vs 8.7 points). Conclusions: Frailty is prevalent in older adults with severe aortic stenosis and is associated with poor physical and mental function, physical well-being, and quality of life. In response to surgery, frail participants exhibited greater improvement in these patient-centered outcomes than non-frail peers.

Original languageEnglish (US)
Pages (from-to)917-921
Number of pages5
JournalJournals of Gerontology - Series A Biological Sciences and Medical Sciences
Volume72
Issue number7
DOIs
StatePublished - Jul 1 2017

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Keywords

  • Aging
  • Healthspan
  • Patient-reported outcomes
  • Physical function
  • Resilience

ASJC Scopus subject areas

  • Aging
  • Geriatrics and Gerontology

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