Key result
Discharge Barthel Index below 60 linked to higher long-term mortality after SAVR.
Why the study?
Few studies have compared the Barthel Index score and postoperative outcomes between patients undergoing TAVR and SAVR.
Does the Barthel Index score predict long-term mortality in patients undergoing TAVR or SAVR?
Cohort (n=605)
No
Does the Barthel Index score predict long-term mortality in patients undergoing TAVR or SAVR?
Hazard Ratio: 0.972 (95% CI 0.94–0.99)
p-value: p=0.028
The Barthel Index score at discharge is a significant predictor of long-term mortality in patients undergoing surgical aortic valve replacement, identifying a cut-off value of 60.0 for increased risk.
BACKGROUND: Few studies have compared the Barthel Index (BI) score and postoperative outcomes of transcatheter aortic valve replacement (TAVR) and surgical aortic valve replacement (SAVR). We aimed to examine the relationship between the BI score and postoperative outcomes in patients who underwent TAVR and SAVR. METHODS AND RESULTS: The study included patients who underwent SAVR between January 2014 and December 2022 (n=293) and patients who underwent TAVR between January 2016 and December 2022 (n=312). We examined the risk factors for long-term mortality in the 2 groups. The mean (±SD) preoperative BI score was 88.7±18.0 in the TAVR group and 95.8±12.3 in the SAVR group. The home discharge rate was significantly lower in the SAVR than TAVR group. The BI score at discharge was significantly higher in the SAVR than in TAVR group (86.2 vs. 80.2; P<0.001). Significant risk factors for long-term mortality in the TAVR group were sex (P<0.001) and preoperative hemoglobin level (P=0.008), whereas those in the SAVR group were preoperative albumin level (P=0.04) and postoperative BI score (P=0.02). The cut-off point of the postoperative BI score determined by receiver operating characteristic curve analysis was 60.0. CONCLUSIONS: The BI score at discharge was a significant risk factor for long-term mortality in the SAVR group, with a cut-off value of 60.0.
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Maze et al. (2023) conducted a cohort in Aortic valve disease requiring replacement (n=605). Barthel Index score at discharge was evaluated on Long-term mortality (SAVR group) (HR 0.972, 95% CI 0.94-0.99, p=0.028). A lower Barthel Index score at discharge was a significant risk factor for long-term mortality in patients undergoing surgical aortic valve replacement (HR 0.972), with an optimal cut-off value of 60.0.
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