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Frailty as a predictor of mortality and readmission rate in secondary mitral regurgitation.

Authors :
Uzel, Robert
Rezar, Richard
Bruno, Raphael Romano
Wernly, Sarah
Jung, Christian
Delle Karth, Georg
Datz, Christian
Hoppichler, Friedrich
Wernly, Bernhard
Source :
Wiener Klinische Wochenschrift; Dec2023, Vol. 135 Issue 23/24, p696-702, 7p
Publication Year :
2023

Abstract

Summary: Introduction: Selection in patients with functional mitral regurgitation (MR) to identify responders to interventions is challenging. In these patients, frailty might be used as a multidimensional parameter to summarize the resilience to stressors. Our objective was to evaluate frailty as a predictor of outcome in patients with moderate to severe secondary MR. Methods: We conducted a single-center retrospective observational cohort study and included 239 patients with moderate to severe secondary MR aged 65 years or older between 2014 and 2020. Echocardiography was performed at baseline; frailty was evaluated using the clinical frailty scale (CFS). The combined primary endpoint was hospitalization for heart failure and all-cause mortality. Results: A total of 53% (127) of all patients were classified as CFS 4 (living with mild frailty) or higher. Frail patients had a higher risk for the combined endpoint (hazard ratio, HR 3.70, 95% confidence interval, CI 2.12–6.47; p < 0.001), 1‑year mortality (HR 5.94, 95% CI 1.76–20.08; p < 0.001) even after adjustment for EuroSCORE2. The CFS was predictive for the combined endpoint (AUC 0.69, 95% CI 0.62–0.75) and outperformed EuroSCORE2 (AUC 0.54, 95% CI 0.46–0.62; p = 0.01). In sensitivity analyses, we found that frailty was associated with adverse outcomes at least in trend in all subgroups. Conclusion: For older, medically treated patients with moderate to severe secondary mitral regurgitation, frailty is an independent predictor for the occurrence of death and heart failure-related readmission within 1 year and outperformed the EuroSCORE2. Frailty should be assessed routinely in patients with heart failure to guide clinical decision making for mitral valve interventions or conservative treatment. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
00435325
Volume :
135
Issue :
23/24
Database :
Complementary Index
Journal :
Wiener Klinische Wochenschrift
Publication Type :
Academic Journal
Accession number :
174164450
Full Text :
https://doi.org/10.1007/s00508-022-02138-4