Effect of transcatheter aortic valve implantation on health-related quality of life in older adults with multimorbidity |
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| Affiliation: | 1. Montreal Behavioural Medicine Centre, Hopital du Sacre-Coeur de Montreal, 5400 Boulevard Gouin Ouest, Montreal, QC H4J 1C5, Canada;2. Research Centre, Montreal Heart Institute – A University of Montréal Affiliated Hospital, 5000, Rue Belanger, Montreal, QC H1T 1C8, Canada;3. Department of Psychology, McGill University, 1205 Dr. Penfield Avenue, Montreal, QC H3A 1B1, Canada;4. Department of Psychology, University of Quebec at Montreal (UQAM), C.P. 8888 succursale Centre-ville, Montréal, QC H3C 3P8, Canada;5. Research Institute of the McGill University Health Centre, 2155 Guy Street, 5th Floor, Montreal, QC H3H 2R9, Canada;6. Division of Clinical Epidemiology, McGill University Health Centre, 687, avenue des Pins Ouest, Montreal, QC H3A 1A1, Canada;7. Department of Psychology, University of Calgary, 2500 University Dr. N.W., Calgary, AB T2N 1N4, Canada;8. Department of Exercise Science, Concordia University, 7141 Sherbrooke Street West, Montreal, QC H4B 1R6, Canada;1. National Institute of Health, Department of Cardiovascular, Dysmetabolic and Aging-Associated Diseases, Rome, Italy;2. Polytechnic University of Marche, Centre of Epidemiology and Biostatistics, Ancona, Italy;3. Italian Society of Nephrology, Italy. Division of Nephrology, University of Campania L. Vanvitelli, Naples, Italy;4. National Association Hospital Cardiologists, Florence, Italy;1. Gérontopôle, Service de Médecine Interne Gériatrique du Pr B. Vellas, CHU Toulouse Hôpital Casselardit, Toulouse, France;2. Pôle Cardiovasculaire et Métabolique, CHU Hopital Rangueil, Toulouse, France;3. Inserm U1027, Toulouse, France;1. Department of Physical Education and Sport, University of Madeira, Funchal, Portugal;2. Madeira Interactive Technologies Institute, Funchal, Portugal;3. Center for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, Geneva, Switzerland;4. Health Administration Institute, Secretary of Health of the Autonomous Region of Madeira, Funchal, Portugal;5. Saint Joseph of Cluny Higher School of Nursing, Funchal, Portugal;6. Department of Psychology, University of Geneva, Geneva, Switzerland;7. Centro Interdisciplinar de Estudo da Performance Humana, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisboa, Portugal;8. Centro de Investigação em Saúde Pública, Escola Nacional de Saúde Pública, Universidade Nova de Lisboa, Lisboa, Portugal;9. Department of Mathematical Sciences, University of Essex, Colchester, UK;1. University of Florida College of Pharmacy, Department of Pharmaceutical Outcomes & Policy, PO Box 100496, Gainesville, FL 32610-0496, United States;2. University of Florida Health Physicians, PO BOX 100354, Gainesville, FL 32610-0354, United States;3. Saint Louis University, College of Public Health and Social Justice, 3545 Lafayette Ave., St. Louis, MO 63104, United States;4. Baptist MD Anderson Cancer Center, Department of Urologic Surgery, 1235 San Marco Blvd., Jacksonville, FL 32207, United States;5. Washington University in St. Louis School of Medicine, Department of Medicine, 4523 Clayton Ave., Campus Box 8051, St. Louis, MO 63110, United States;6. SSM Health, Department of Clinical Analytics and Insights, 10101 Woodfield Lane, St. Louis, MO 63132, United States;1. Clinical Pharmacology Research Unit, Heymans Institute of Pharmacology, Ghent University, C. Heymanslaan 10, 9000 Gent, Belgium;2. End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) & Ghent University, Laarbeeklaan 103, 1090 Brussels, Belgium;3. Faculty of Medicine and Health Sciences, Department of Nursing Science, Centre for Research and Innovation in Care (NuPhaC), University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Belgium;4. Department of Nursing and Midwifery, Thomas More University College, Antwerpsestraat 99, 2500 Lier, Belgium;5. Department of Public Health and Primary Care, Ghent University Hospital, C. Heymanslaan 10, 9000 Gent, Belgium |
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| Abstract: | PurposeThe purpose of this study was to determine the effect of transcatheter aortic valve implantation on health-related quality of life in older adults with multimorbidity and to evaluate the predictive factors for postoperative quality of life impairment in such patients.Material and methodThis study included 141 older adults with severe aortic stenosis scheduled for elective transcatheter aortic valve implantation. Quality of life was examined in all patients using the Short-Form 36 Health Survey Questionnaire, before and 2 years after surgery. Comorbidity was assessed using the Charlson Comorbidity Index.ResultsIn older adult patients with aortic stenosis and multimorbidity, transcatheter aortic valve implantation significantly improved both physical and mental components of quality of life 2 years after surgery. A Charlson Comorbidity Index ≥5 points was independently associated with the absence of positive dynamics in Physical Health score [odds ratio (OR) 0.38 (0.20–0.75), p = 0.007]. Charlson Comorbidity Index ≥5 points [OR 0.31 (0.19–0.58), p = 0.026] and new-onset arrhythmia [OR 0.54 (0.38–0.78), p = 0.017] were independent predictors of the absence of positive dynamics in Mental Health score after transcatheter aortic valve implantation.ConclusionsHigh-level comorbidity (Charlson Comorbidity Index ≥5 points) predicts both Physical and Mental Health scores for quality of life impairment following transcatheter aortic valve implantation in older adults, and new-onset arrhythmia predicts the Mental Health score for quality of life impairment following transcatheter aortic valve implantation in these patients. |
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| Keywords: | Aortic stenosis Charlson Comorbidity Index Quality of life Transcatheter aortic valve implantation |
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