What is the clinical evidence from this study?

Study design: Cohort. Population: Symptomatic aortic stenosis (n=493). Intervention: Surgical aortic valve replacement (AVR). Primary outcome: 6-month mortality.

What question did this study set out to answer?

To identify high-risk clinical factors and define selection criteria for octogenarians undergoing surgical aortic valve replacement in the context of emerging transcatheter therapies.

February 2, 2010European Journal of Cardio-Thoracic SurgeryOpen Access

Aortic valve replacement in octogenarians: identification of high-risk patients

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Key result

In octogenarians undergoing surgical aortic valve replacement, independent risk factors for 6-month mortality included age >84 years (OR 2.2), LVEF <60% (OR 2.5), and BMI <24 (OR 2.0).

Why the study?

What are the independent risk factors for 6-month mortality in octogenarians undergoing surgical aortic valve replacement?

Population

493 consecutive octogenarians with symptomatic aortic stenosis

Design

Cohort

Follow-up

up to 5 years

Authors

IFInes FlorathCurtin University ABAndreas BoeningInterventional / Structural Cardiology IEI. C. EnnkerHNO-Praxis

Discussion

Member takes

Implication

May aid preoperative risk stratification in octogenarian SAVR candidates; leaves open prospective validation for TAVR selection.

Key Points

To identify high-risk clinical factors and define selection criteria for octogenarians undergoing surgical aortic valve replacement in the context of emerging transcatheter therapies.
Retrospective cohort analysis of 493 consecutive octogenarians with symptomatic aortic stenosis undergoing aortic valve replacement, with or without concomitant CABG (51%), between 1996 and 2006.
Multivariable logistic regression analysis performed to determine independent predictors of 6-month post-procedural mortality.
Overall 30-day mortality was 8.4%, rising to 15.2% at 6 months post-surgery.
Independent risk factors for 6-month mortality included age >84 years (OR 2.2, 95% CI 1.29–3.61), left ventricular ejection fraction <60% (OR 2.5, 95% CI 1.35–4.61), BMI <24 kg/m² (OR 2.0, 95% CI 1.22–3.36), creatinine (OR 1.6, 95% CI 1.04–2.53), and elevated blood glucose (OR 1.01, 95% CI 1.001–1.009).
High-risk subsets comprised 37% of patients; those older than 84 with ejection fraction <60% experienced a 6-month mortality of 28%, while patients under 84 with ejection fraction <60% and BMI <24 experienced a 6-month mortality of 23.2%.

Study Design

Type

Cohort (n=493)

Structured PICO

What are the independent risk factors for 6-month mortality in octogenarians undergoing surgical aortic valve replacement?

Population

493 consecutive octogenarians with symptomatic aortic stenosis undergoing surgical aortic valve replacement with or without CABG, evaluated for 6-month mortality.

Exposure

Surgical aortic valve replacement (AVR) with or without concomitant coronary artery bypass grafting (CABG)

Outcome

6-month mortalityhard clinical

In octogenarians undergoing surgical AVR, simple clinical factors (age >84 years, LVEF <60%, and BMI <24) can identify high-risk patients who may be better candidates for transcatheter therapies.

Cite This Study

Florath et al. (2010) conducted a cohort in Symptomatic aortic stenosis (n=493). Surgical aortic valve replacement (AVR) was evaluated on 6-month mortality. In octogenarians undergoing surgical aortic valve replacement, independent risk factors for 6-month mortality included age >84 years (OR 2.2), LVEF <60% (OR 2.5), and BMI <24 (OR 2.0).

synapsesocial.com/papers/6a9c511d0a89ed3e75241c26 https://doi.org/10.1016/j.ejcts.2009.12.025

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February 2, 2010European Journal of Cardio-Thoracic SurgeryOpen Access

Aortic valve replacement in octogenarians: identification of high-risk patients

View Full Paper

Ask AI

Bookmark

Key result

In octogenarians undergoing surgical aortic valve replacement, independent risk factors for 6-month mortality included age >84 years (OR 2.2), LVEF <60% (OR 2.5), and BMI <24 (OR 2.0).

Why the study?

What are the independent risk factors for 6-month mortality in octogenarians undergoing surgical aortic valve replacement?

Population

493 consecutive octogenarians with symptomatic aortic stenosis

Design

Cohort

Follow-up

up to 5 years

Authors

IFInes FlorathCurtin University ABAndreas BoeningInterventional / Structural Cardiology IEI. C. EnnkerHNO-Praxis

Discussion

Member takes

Implication

May aid preoperative risk stratification in octogenarian SAVR candidates; leaves open prospective validation for TAVR selection.

Key Points

To identify high-risk clinical factors and define selection criteria for octogenarians undergoing surgical aortic valve replacement in the context of emerging transcatheter therapies.
Retrospective cohort analysis of 493 consecutive octogenarians with symptomatic aortic stenosis undergoing aortic valve replacement, with or without concomitant CABG (51%), between 1996 and 2006.
Multivariable logistic regression analysis performed to determine independent predictors of 6-month post-procedural mortality.
Overall 30-day mortality was 8.4%, rising to 15.2% at 6 months post-surgery.
Independent risk factors for 6-month mortality included age >84 years (OR 2.2, 95% CI 1.29–3.61), left ventricular ejection fraction <60% (OR 2.5, 95% CI 1.35–4.61), BMI <24 kg/m² (OR 2.0, 95% CI 1.22–3.36), creatinine (OR 1.6, 95% CI 1.04–2.53), and elevated blood glucose (OR 1.01, 95% CI 1.001–1.009).
High-risk subsets comprised 37% of patients; those older than 84 with ejection fraction <60% experienced a 6-month mortality of 28%, while patients under 84 with ejection fraction <60% and BMI <24 experienced a 6-month mortality of 23.2%.

Study Design

Type

Cohort (n=493)

Structured PICO

What are the independent risk factors for 6-month mortality in octogenarians undergoing surgical aortic valve replacement?

Population

493 consecutive octogenarians with symptomatic aortic stenosis undergoing surgical aortic valve replacement with or without CABG, evaluated for 6-month mortality.

Exposure

Surgical aortic valve replacement (AVR) with or without concomitant coronary artery bypass grafting (CABG)

Outcome

6-month mortalityhard clinical

In octogenarians undergoing surgical AVR, simple clinical factors (age >84 years, LVEF <60%, and BMI <24) can identify high-risk patients who may be better candidates for transcatheter therapies.

Cite This Study

synapsesocial.com/papers/6a9c511d0a89ed3e75241c26 https://doi.org/10.1016/j.ejcts.2009.12.025

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