Eichler S, et al. - Here, the researchers evaluated pre-interventional predictors for all-cause mortality in patients after transcatheter aortic valve implantation (TAVI) with a 12-month follow-up. Nutrition status and mobility of patients scheduled for TAVI offered prognostic information for 1-year all-cause mortality, besides EuroSCORE and diabetes mellitus. Particularly, nutrition status and mobility ought to be advocated in the creation of contemporary TAVI risk scores.

Methods

• The researchers consecutively enrolled 344 patients (80.9 ± 5.0 years, 44.5% male) with an elective TAVI in a prospective, multicentre cohort study, from 10/2013 to 07/2015.
• Sociodemographic parameters, echocardiographic data, and comorbidities were documented, prior to the intervention.
• For this study, all patients completed a 6-min walk test, Short Form 12 and a Frailty Index (score consisting of activities of daily living, cognition, nutrition, and mobility).
• They documented peri-interventional complications.
• They assessed vital status over telephone 12 months after TAVI.
• Using a multivariate regression model, predictors for all-cause mortality were identified.

Results

• In this study, 333 patients were alive (in-hospital mortality 3.2%; n = 11) at discharge.
• Forty-six patients (13.8%) died during a follow-up of 381.0 ± 41.9 days.
• The non-survivors were found to be older (82.3 ± 5.0 vs. 80.6 ± 5.1 years; p=0.035), who had a higher number of comorbidities (2.6 ± 1.3 vs. 2.1 ± 1.3; p=0.026) and a lower left ventricular ejection fraction (51.0 ± 13.6 vs. 54.6 ± 10.6%; p=0.048).
• Additionally, more suffered from diabetes mellitus (60.9 vs. 44.6%; p=0.040).
• The researchers found no predictive power of the global Frailty Index, however, its individual components, especially nutrition (OR 0.83 per 1 pt., CI 0.72-0.95; p=0.006) and mobility (OR 5.12, CI 1.64-16.01; p=0.005) had a prognostic impact.
• Similarly, diabetes mellitus (OR 2.18, CI 1.10-4.32; p=0.026) and EuroSCORE (OR 1.21 per 5%, CI 1.07–1.36; p=0.002) were correlated with a higher risk of all-cause mortality.