title: Frailty after aortic valve replacement (AVR) in octogenarians.
abstract: In order to analyze the quality of life (QoL) or frailty after AVR for octogenarians, we studied 84 patients older than 80 years who underwent aortic valve replacement alone or in combination with coronary artery bypass, between April 1998 and December 2001. Follow-up was performed in May 2002 with a telephonic interview to evaluate the self-rated QoL, health, and three frailty markers: falls, activity of daily living (ADL) and mood disorder. In-hospital mortality was 16.7%. Fourteen deaths occurred during the follow-up: survival estimates were 85.5% at 1 year and 68.6% at 3 years. Forty-one patients (73.2%) were in New York Heart Association (NYHA) classes I-II for dyspnea and 42 patients (75.0%) were free of angina. Fifty-one patients (91.1%) lived in their own homes. Forty-eight (85.7%) had at least one frailty marker: falls (26.8%), loss of autonomy for ADL (27.0%) or suspected depression (20.2%). All frailty markers were associated with self-rated QoL but not with self-rated health. AVR for octogenarians is associated with good outcome but this population is frail and further studies should assess the usefulness of pre- and postoperative geriatric approach.
authors.affiliation: Centre Cardiologique du Nord, Service de chirurgie cardiaque, 32 rue des Moulins Gémeaux, 93200 Saint-Denis, France. jm.maillet@ccncardio.com
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Maillet
authors.forename: Dominique
authors.initials: D
authors.lastname: Somme
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Hennel
authors.forename: Arrigo
authors.initials: A
authors.lastname: Lessana
authors.forename: Olivier
authors.initials: O
authors.lastname: Saint-Jean
authors.forename: Denis
authors.initials: D
authors.lastname: Brodaty
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data; D000203:Activities of Daily Living; D000369:Aged, 80 and over; D001024:Aortic Valve Stenosis / Q000401:mortality / Q000601:surgery*; D016009:Chi-Square Distribution; D001026:Coronary Artery Bypass; D005260:Female; D005500:Follow-Up Studies; D016330:Frail Elderly; D015577:Geriatric Assessment; D019918:Heart Valve Prosthesis Implantation / Q000401:mortality; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D019964:Mood Disorders / Q000453:epidemiology; D011788:Quality of Life; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D016896:Treatment Outcome