title: Impact of frailty scores on outcome of octogenarian patients undergoing transcatheter aortic valve implantation.
abstract: BACKGROUND
  For selected patients with symptomatic aortic stenosis, transcatheter aortic valve implantation (TAVI) is an alternative to surgical aortic valve replacement (AVR). In addition to co-morbidities, frailty has to be taken into account in the decision-making process. Criteria for patient selection, according to current guidelines, include EuroSCORE and STS score but frailty is not easy to quantify. ISAR (Identification of Seniors At Risk) detects seniors at risk for adverse health outcome after an emergency visit and SHERPA (Score Hospitalier d'Evaluation du Risque de Perte d'Autonomie) assesses the risk of functional decline after hospitalization.
  
  
  OBJECTIVE
  The aim of the present study was to evaluate the impact of ISAR and SHERPA scores in the prediction of patient outcome afterTAVI.
  
  
  RESULTS
  A prospective cohort of 30 consecutive octogenarian patients (16 males, 86 +/- 3 y, EuroSCORE 34 +/- 12%) underwent a transfemoral TAVI and a complete geriatric assessment in our institution. Survival at one year was 73%. The ISAR score was similar between both groups (3.1 +/- 1 vs. 3.6 +/- 1; P = 0.10) but the SHERPA score was significantly higher in non-survivors (7.8 +/- 1.6) than among survivors (4.9 +/- 2.4; P = 0.001). With multivariate analysis, SHERPA score and BMI were independent predictors of 1-year mortality. Kaplan-Meier analysis showed that 1-year survival was significantly lower in patients with than in those without a SHERPA score > 7 (40 vs. 89%; P = 0.004).
  
  
  CONCLUSIONS
  The result of this study showed that SHERPA score predicts 1-year survival after transfemoral TAVI and could be considered as a useful frailty score in patient selection.
authors.affiliation: Division of Cardiology, Cliniques Universitaires Saint-Luc, University of Louvain, Brussels, Belgium.
authors.forename: Michele
authors.initials: M
authors.lastname: Kamga
authors.affiliation: Division of Geriatrics, Cliniques Universitaires Saint-Luc, University of Louvain, Brussels, Belgium.
authors.forename: Benoit
authors.initials: B
authors.lastname: Boland
authors.affiliation: Division of Geriatrics, Cliniques Universitaires Saint-Luc, University of Louvain, Brussels, Belgium.
authors.forename: Pascale
authors.initials: P
authors.lastname: Cornette
authors.affiliation: Division of Geriatrics, Cliniques Universitaires Saint-Luc, University of Louvain, Brussels, Belgium.
authors.forename: Marianne
authors.initials: M
authors.lastname: Beeckmans
authors.affiliation: Division of Cardiology, Cliniques Universitaires Saint-Luc, University of Louvain, Brussels, Belgium.
authors.forename: Christophe
authors.initials: C
authors.lastname: De Meester
authors.affiliation: Division of Cardiology, Cliniques Universitaires Saint-Luc, University of Louvain, Brussels, Belgium.
authors.forename: Patrick
authors.initials: P
authors.lastname: Chenu
authors.affiliation: Division of Cardiology, Cliniques Universitaires Saint-Luc, University of Louvain, Brussels, Belgium.
authors.forename: Olivier
authors.initials: O
authors.lastname: Gurné
authors.affiliation: Division of Cardiology, Cliniques Universitaires Saint-Luc, University of Louvain, Brussels, Belgium.
authors.forename: Jean
authors.initials: J
authors.lastname: Renkin
authors.affiliation: Division of Cardiology, Cliniques Universitaires Saint-Luc, University of Louvain, Brussels, Belgium.
authors.forename: Joëlle
authors.initials: J
authors.lastname: Kefer
mesh_terms: D000367:Age Factors; D000369:Aged, 80 and over; D001024:Aortic Valve Stenosis / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D001530:Belgium / Q000453:epidemiology; D006328:Cardiac Catheterization; D005260:Female; D016330:Frail Elderly; D015577:Geriatric Assessment / Q000379:methods*; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D008297:Male; D011446:Prospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D012720:Severity of Illness Index; D015996:Survival Rate / Q000639:trends; D013997:Time Factors