title: Frailty is associated with delirium and mortality after transcatheter aortic valve implantation.
abstract: We hypothesised that frailty assessment is of additional value to predict delirium and mortality after transcatheter aortic valve implantation (TAVI).
  
  
  
  Observational study in 89 consecutive patients who underwent TAVI. Inclusion from November 2012 to February 2014, follow-up until April 2014. Measurement of the association of variables from frailty assessment and cardiological assessment with delirium and mortality after TAVI, respectively.
  
  
  
  Incidence of delirium after TAVI: 25/89 (28%). Variables from frailty assessment protectively associated with delirium were: Mini Mental State Examination, (OR 0.79; 95% CI 0.65 to 0.96; p=0.02), Instrumental Activities of Daily Living (OR 0.79; 95% CI 0.63 to 0.99; p=0.04) and gait speed (OR 0.05; 95% CI 0.01 to 0.50; p=0.01). Timed Up and Go was predictively associated with delirium (OR 1.14; 95% CI 1.03 to 1.26; p=0.01). From cardiological assessment, pulmonary hypertension was protectively associated with delirium (OR 0.34; 95% CI 0.12 to 0.98; p=0.05). Multivariate logistic analysis: Nagelkerke R2=0.359, Mini Mental State Examination was independently associated with delirium. Incidence of mortality: 11/89 (12%). Variables predictively associated with mortality were: the summary score Frailty Index (HR 1.66, 95% CI 1.06 to 2.60; p=0.03), European System for Cardiac Operative Risk Evaluation (EuroSCORE) II (HR 1.14, 95% CI 1.06 to 1.22; p<0.001) and complications (HR 4.81, 95% CI 1.03 to 22.38; p=0.05). Multivariate Cox proportional hazards analysis: Nagelkerke R2=0.271, Frailty Index and EuroSCORE II were independently associated with mortality.
  
  
  
  Delirium frequently occurs after TAVI. Variables from frailty assessment are associated with delirium and mortality, independent of cardiological assessment. Thus, frailty assessment may have additional value in the prediction of delirium and mortality after TAVI.
authors.affiliation: Department of Primary and Elderly Care, Radboud University Medical Centre Nijmegen, The Netherlands; ZZG Care Group, Nijmegen, The Netherlands.
authors.forename: Patricia
authors.initials: P
authors.lastname: Assmann
authors.affiliation: Department of Cardiology , Radboud University Medical Centre Nijmegen , The Netherlands.
authors.forename: Peter
authors.initials: P
authors.lastname: Kievit
authors.affiliation: Department of Cardiology , Radboud University Medical Centre Nijmegen , The Netherlands.
authors.forename: Kees
authors.initials: K
authors.lastname: van der Wulp
authors.affiliation: Department of Cardio-Thoracic Surgery , Radboud University Medical Centre Nijmegen , The Netherlands.
authors.forename: Michel
authors.initials: M
authors.lastname: Verkroost
authors.affiliation: Department of Cardio-Thoracic Surgery , Radboud University Medical Centre Nijmegen , The Netherlands.
authors.forename: Luc
authors.initials: L
authors.lastname: Noyez
authors.affiliation: Department of Primary and Elderly Care , Radboud University Medical Centre Nijmegen , The Netherlands.
authors.forename: Hans
authors.initials: H
authors.lastname: Bor
authors.affiliation: Department of Geriatrics , Radboud University Medical Centre Nijmegen , The Netherlands.
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Schoon
keywords: TAVI; delirium; frailty assessment; mortality