September 1, 2005European Heart Journal
Decision-making in elderly patients with severe aortic stenosis: why are so many denied surgery?
Why the study?
What factors are associated with the decision to deny surgery in elderly patients with severe, symptomatic aortic stenosis?
Population
216 patients aged >=75 years with severe, symptomatic aortic stenosis from the Euro Heart Survey.
Comparison
Decision not to operate vs Decision to operate
Design
Cohort
Authors
Discussion
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Member takes
Implication
Age and LV dysfunction, not comorbidity burden, drive surgical denial in elderly severe AS; leaves open need for refined decision aids.
Structured PICO
What factors are associated with the decision to deny surgery in elderly patients with severe, symptomatic aortic stenosis?
P
Population
216 patients aged >=75 years with severe, symptomatic aortic stenosis (valve area <=0.6 cm2/m2 body surface area or mean gradient >=50 mmHg, and angina or NYHA class III or IV) from the Euro Heart Survey.
I
Intervention
Decision not to operate
C
Comparator
Decision to operate
O
Outcome
Factors associated with the decision not to operate
In elderly patients with severe symptomatic aortic stenosis, surgery is frequently denied (33%), primarily driven by older age and LV dysfunction rather than overall comorbidity burden.
Cite This Study
Iung et al. (2005) studied this question.