Abstract:
:Background: Current surgical risk assessment tools fall short of appreciating geriatric risk factors including cognitive deficits, depressive, and frailty symptoms that may worsen outcomes post-transcatheter aortic valve implantation (TAVI). This study hypothesized that a screening tool, SMARTIE, would improve detection of these risks pre-TAVI, and thus be predictive of postoperative delirium (POD) and 30-day mortality post-TAVI. Design: Prospective observational cohort study, using a historical cohort for comparison. Participants: A total of 234 patients (age: 82.2±6.7 years, 59.4% male) were included. Half were screened using SMARTIE. Methods: The SMARTIE cohort was assessed for cognitive deficits and depressive symptoms using the Mini-Cog test and PHQ-2, respectively. Measures of frailty included activities of daily living inventory, the Timed Up and Go test and grip strength. For the pre-SMARTIE cohort, we extracted cognitive deficits, depression and frailty symptoms from clinic charts. The incidence of POD and 30-day mortality were recorded. Bivariate chi-square analysis or t-tests were used to report associations between SMARTIE and pre-SMARTIE groups. Multivariable logistic regression models were employed to identify independent predictors of POD and 30-day mortality. Results: More patients were identified with cognitive deficits (χ2=11.73, p=0.001), depressive symptoms (χ2=8.15, p=0.004), and physical frailty (χ2=5.73, p=0.017) using SMARTIE. Cognitive deficits were an independent predictor of POD (OR: 8.4, p<0.01) and 30-day mortality (OR: 4.04, p=0.03). Conclusion: This study emphasized the value of screening for geriatric risk factors prior to TAVI by demonstrating that screening increased identification of at-risk patients. It also confirmed findings that cognitive deficits are predictive of POD and mortality following TAVI.
journal_name
Clin Interv Agingjournal_title
Clinical interventions in agingauthors
Khan MM,Lanctôt KL,Fremes SE,Wijeysundera HC,Radhakrishnan S,Gallagher D,Gandell D,Brenkel MC,Hazan EL,Docteur NG,Herrmann Ndoi
10.2147/CIA.S201615subject
Has Abstractpub_date
2019-05-08 00:00:00pages
841-848eissn
1176-9092issn
1178-1998pii
201615journal_volume
14pub_type
杂志文章abstract:Background:Care transitions programs are increasingly used to improve care and reduce re-admission of patients after hospitalization. To learn from the experience of patients who have participated in the Mayo Clinic Care Transitions (MCCT) program and to understand the patient experience, we sought perspectives of pati...
journal_title:Clinical interventions in aging
pub_type: 杂志文章
doi:10.2147/CIA.S183893
更新日期:2018-12-19 00:00:00
abstract:Introduction:Paternalism, assuming control of aged care, is a widespread orientation in older adults care. Paternalistic attitudes and practices are commonly understood as a threat to the freedom and autonomy of a person, making patients more dependent. Therefore, the reduction of these attitudes and behaviors is a pri...
journal_title:Clinical interventions in aging
pub_type: 杂志文章
doi:10.2147/CIA.S213644
更新日期:2019-08-26 00:00:00
abstract:Background:Postoperative functional training for fracture or osteoarthritis is mainly focused on functional self-exercise, which aims to recover the function of the lower limbs. Purpose:To compare the function and life quality recovery in patients with fracture or arthritis treated with novel muscle training device (N...
journal_title:Clinical interventions in aging
pub_type: 杂志文章
doi:10.2147/CIA.S277118
更新日期:2020-11-18 00:00:00
abstract:PURPOSE:In a collaborative effort between the Missouri Department of Health, Area Agencies on Aging (AAA), Alzheimer Association, and academic researchers, we tested whether early dementia detection and comprehensive care consultations would improve health outcomes in care receivers (CRs) and their family caregivers (F...
journal_title:Clinical interventions in aging
pub_type: 临床试验,杂志文章,多中心研究
doi:10.2147/CIA.S60838
更新日期:2014-04-10 00:00:00
abstract:Purpose:The incidence of proximal humeral fractures is high in the elderly, and the superior management of these fractures remains a controversy. The study aims to compare clinical outcomes of intramedullary nails, locking plates and conservative treatment for the management of displaced proximal humeral fractures in t...
journal_title:Clinical interventions in aging
pub_type: 临床试验,杂志文章
doi:10.2147/CIA.S144084
更新日期:2017-11-29 00:00:00
abstract:PURPOSE:Cognitive screening upon hospital admission can provide important information about the patient's ability to process information during the inpatient stay. The Clock-in-the-Box (CIB) is a rapidly administered cognitive screening measure which has been previously validated with cognitive screening and neuropsych...
journal_title:Clinical interventions in aging
pub_type: 杂志文章
doi:10.2147/CIA.S118235
更新日期:2016-11-22 00:00:00
abstract::Taken once a year, intravenous zoledronic acid (Zol) (Reclast® or Aclasta®) is a third-generation nitrogen-containing bisphosphonate that is effective compared with placebo in reducing the risk of fractures in patients with postmenopausal osteoporosis and recent low-trauma hip fracture. In glucocorticoid-induced osteo...
journal_title:Clinical interventions in aging
pub_type: 杂志文章,评审
doi:10.2147/CIA.S7282
更新日期:2011-01-01 00:00:00
abstract::The use of atypical antipsychotic drugs in the elderly has become wider and wider in recent years; in fact, these agents have novel receptor binding profiles, good efficacy with regard to negative symptoms, and reduced extrapyramidal symptoms. However, in recent years, the use of both conventional and atypical antipsy...
journal_title:Clinical interventions in aging
pub_type: 杂志文章,评审
doi:10.2147/CIA.S63942
更新日期:2014-08-16 00:00:00
abstract::Fluctuating Parkinson's disease (PD) represents a clinical management challenge. The primary utility of levodopa in patients with PD is moderated by the "wearing off" phenomena seen with long-term use. COMT inhibitors slow down the rapid metabolism of levodopa, resulting in a more-sustained response to dopaminergic th...
journal_title:Clinical interventions in aging
pub_type: 杂志文章,评审
doi:10.2147/ciia.2006.1.4.317
更新日期:2006-01-01 00:00:00
abstract:Purpose:Ever-increasing noncardiac surgeries are performed in patients aged 80 years or over with coronary artery disease (CAD). The objective of the study was to explore the incidence and risk factors of perioperative cardiac complications (PCCs) for the oldest-old patients with CAD undergoing noncardiac surgery, whic...
journal_title:Clinical interventions in aging
pub_type: 杂志文章
doi:10.2147/CIA.S252160
更新日期:2020-07-17 00:00:00
abstract::Evidence of epidemiological associations of vitamins and disease states have been found for nine vitamins. In observational studies, people with a high intake of antioxidant vitamins by regular diet or as food supplements generally have a lower risk of major chronic disease, such as myocardial infarction or stroke, th...
journal_title:Clinical interventions in aging
pub_type: 杂志文章,评审
doi:10.2147/ciia.2006.1.1.81
更新日期:2006-01-01 00:00:00
abstract:BACKGROUND:Atrial fibrillation (AF) disproportionately affects older adults. However, direct comparison of clinical features, medical therapy, and outcomes in AF patients aged 65-74 and ≥ 75 years is rare. The objective of the present study was to evaluate the differences in clinical characteristics and prognosis in th...
journal_title:Clinical interventions in aging
pub_type: 杂志文章,多中心研究
doi:10.2147/CIA.S67123
更新日期:2014-08-12 00:00:00
abstract:BACKGROUND:Research on crisis teams for older adults with dementia is limited. This scoping review aimed to 1) conduct a systematic literature review reporting on the effectiveness of crisis interventions for older people with dementia and 2) conduct a scoping survey with dementia crisis teams mapping services across E...
journal_title:Clinical interventions in aging
pub_type: 杂志文章,评审
doi:10.2147/CIA.S142341
更新日期:2017-10-03 00:00:00
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journal_title:Clinical interventions in aging
pub_type: 杂志文章
doi:10.2147/CIA.S64718
更新日期:2014-10-13 00:00:00
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journal_title:Clinical interventions in aging
pub_type:
doi:10.2147/CIA.S277762
更新日期:2020-12-08 00:00:00
abstract::In the elderly population, osteoporosis is a significant clinical problem leading to disability and even death. Many patients remain untreated, despite effective therapies, because of patients' unwillingness to take current therapies or inability to tolerate the therapies. For this reason, ongoing research continues t...
journal_title:Clinical interventions in aging
pub_type: 杂志文章,评审
doi:
更新日期:2007-01-01 00:00:00
abstract:Purpose:Sleep disorders, such as insomnia with objective short sleep duration, are associated with increased risk of hypertension. The objective of the study was to evaluate the effects of insomnia and daytime sleepiness on the quality of life (QOL) among elderly hypertensive patients. Patients and methods:This cross-...
journal_title:Clinical interventions in aging
pub_type: 杂志文章
doi:10.2147/CIA.S188499
更新日期:2019-01-15 00:00:00
abstract::Data on the oral health of the elderly depict a worrying situation, with an elevated prevalence of caries and moderate periodontal disease, frequent edentulism, and numerous cases of dry mouth and oral cancer. There is wide evidence that periodontitis is a risk factor for certain systemic diseases, and impaired oral h...
journal_title:Clinical interventions in aging
pub_type: 杂志文章,评审
doi:10.2147/CIA.S54630
更新日期:2015-02-11 00:00:00
abstract:Purpose:The purpose of this study was to identify how changes to general health might affect the oral health of nursing-home residents over a six-month period. Materials and Methods:The study was conducted in nine nursing homes in Germany. Sociodemographic and general data were collected at baseline and after six mont...
journal_title:Clinical interventions in aging
pub_type: 杂志文章
doi:10.2147/CIA.S234938
更新日期:2020-01-09 00:00:00
abstract:OBJECTIVE:To estimate the value of the different thromboelastogram indices for predicting hemorrhage and vascular obstruction in an elderly population. METHODS:This was a prospective cohort study of patients 65 years and older without hemato-logic disorders who received thromboelastography (TEG) examination at the Chi...
journal_title:Clinical interventions in aging
pub_type: 杂志文章
doi:10.2147/CIA.S49478
更新日期:2013-01-01 00:00:00
abstract:Purpose:Vestibular rehabilitation (VR) using posturography systems has proved useful in improving balance among elderly patients with postural instability. However, its high cost hinders its use. The objective of this study is to assess whether two different protocols of VR with posturography, one of them longer (ten s...
journal_title:Clinical interventions in aging
pub_type: 杂志文章,随机对照试验
doi:10.2147/CIA.S263302
更新日期:2020-06-26 00:00:00
abstract::Idiopathic normal pressure hydrocephalus (iNPH) is a rare neurological disorder with no clear prevalence factors and is a significant danger to the elderly. The intracranial glymphatic system is the internal environment that maintains brain survival and metabolism, and thus fluid exchange changes in the glymphatic sys...
journal_title:Clinical interventions in aging
pub_type: 杂志文章,评审
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更新日期:2021-01-15 00:00:00
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journal_title:Clinical interventions in aging
pub_type: 杂志文章
doi:10.2147/CIA.S71878
更新日期:2014-12-19 00:00:00
abstract:Background:Being elderly and retired are related phenomena that overlap in a time symmetry. The present study aimed to assess the effect of an empowering self-management model on the self-efficacy and sense of coherence (SOC) in retired elderly with chronic diseases. Methods:A randomized controlled trial that included...
journal_title:Clinical interventions in aging
pub_type: 杂志文章,随机对照试验
doi:10.2147/CIA.S183276
更新日期:2018-11-01 00:00:00
abstract::The percentage of the population described as elderly is growing, and a higher prevalence of multiple, chronic disease states must be managed concurrently. Healthcare practitioners must appropriately use medication for multiple diseases and avoid risks often associated with multiple medication use such as adverse effe...
journal_title:Clinical interventions in aging
pub_type: 杂志文章
doi:10.2147/cia.s2468
更新日期:2008-01-01 00:00:00
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journal_title:Clinical interventions in aging
pub_type: 杂志文章,随机对照试验
doi:10.2147/CIA.S173696
更新日期:2018-10-18 00:00:00
abstract::Life-space mobility (LSM) is a concept for assessing patterns of functional mobility over time. LSM is gaining traction in the research of geriatric population health. Several instruments have been developed to measure LSM, such as the University of Alabama at Birmingham Life-Space Assessment (LSA) or the Nursing Home...
journal_title:Clinical interventions in aging
pub_type: 杂志文章,评审
doi:10.2147/CIA.S196944
更新日期:2020-09-15 00:00:00
abstract:Purpose:This study aimed to investigate the effect of religious intervention on depressive symptoms and quality of life (QOL) among Indonesian elderly in nursing homes (NHs). Patients and methods:This was a quasi-experimental study with repeated measures. Sixty elderly residents at three NHs in three districts in Yogy...
journal_title:Clinical interventions in aging
pub_type: 杂志文章
doi:10.2147/CIA.S162946
更新日期:2018-03-23 00:00:00
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journal_title:Clinical interventions in aging
pub_type: 杂志文章,评审
doi:10.2147/CIA.S36367
更新日期:2013-01-01 00:00:00
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journal_title:Clinical interventions in aging
pub_type: 杂志文章
doi:10.2147/CIA.S281290
更新日期:2020-12-01 00:00:00