A Comprehensive Geriatric Workup and Frailty Assessment in Older Patients with Severe Aortic Stenosis

Journal of Clinical Medicine, Journal Year: 2024, Volume and Issue: 13(14), P. 4169 - 4169

Published: July 16, 2024

Aortic stenosis (AS) represents a notable paradigm for cardiovascular (CV) and geriatric disorders owing to comorbidity. Transcatheter aortic valve replacement (TAVR) was initially considered therapeutic strategy in elderly individuals deemed unsuitable or at high risk of surgical replacement. The progressive improvement TAVR technology has led the need refine older patients’ stratification, progressively incorporating concept frailty other vulnerabilities. Recognizing intricate nature aging process, reliance exclusively on chronological age stratification resulted an initial but inadequate tool assess both CV non-CV risks effectively. A comprehensive evaluation should be performed before procedures, taking into account physical cognitive capabilities post-procedural outcomes through multidisciplinary framework. This review adopts perspective delve diagnosis holistic management AS populations order facilitate decision-making, thereby optimizing centered around patient well-being.

Language: Английский

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The Impact of Frailty on VARC-3 Integrated Outcomes in Patients Undergoing Transcatheter Aortic Valve Replacement

JACC Advances, Journal Year: 2025, Volume and Issue: 4(3), P. 101594 - 101594

Published: Feb. 14, 2025

Language: Английский

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Frailty as a Predictor of Net Clinical Benefit in Atrial Fibrillation Patients Over 60 Receiving Anticoagulants: Insights from the Single-Center Prospective REGATTA-2 Registry

Russian Journal of Geriatric Medicine, Journal Year: 2025, Volume and Issue: 1, P. 49 - 57

Published: Feb. 19, 2025

Studying the frailty in patients with atrial fibrillation (AF) is essential given high prevalence of AF and escalating risk strokes bleeding as individuals age. AIM : to evaluate effect on sum thromboembolic events bleedings aged 60 years older receiving anticoagulants. MATERIALS AND METHODS . This fragment from single-center prospective REGATTA-2 register (Register long-term Antithrombotic therapy -NCT043447187) included 455 ≥ for whom it was possible assess signs three scales Groningen Frailty Index, FRAIL «Age not a hindrance». During follow-up (median 6 years), were taken into. RESULTS according Index detected 29.7% 31.8%, using hindrance» scale — 9.5% patients. The most common syndromes emotional cognitive disorders, fatigue limited mobility. According ROC analysis, all used had predictive value relation bleedings. Independent predictors (Cox proportional risks model) are 4 (HR=1.8) 3 (HR=1.6). CONCLUSION Frail have an increased bleedings; therefore, they need personalized monitoring treatment regimen.

Language: Английский

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Relationship between immediate memory, depressive symptomatology and loneliness in older adults: a longitudinal study

Aging & Mental Health, Journal Year: 2025, Volume and Issue: unknown, P. 1 - 8

Published: April 17, 2025

We aimed to study the longitudinal relationship between immediate memory, depressive symptomatology and loneliness controlling for age number of chronic diseases over time. The sample consisted 64,887 participants from three consecutive waves Survey Health, Ageing Retirement in Europe project, aged 50 or older at first time (M = 66.68, SD 10.034). used cross-lagged panel model. Within each temporal moment, associations memory symptomatology, were negative. Associations positive. These variables feedback on other through small medium effects. Immediate is more affected by than loneliness. However, may exert a greater negative effect, relative terms, when it coexists with symptomatology. Depressive deficits. deficits affect terms because such are exacerbated elevated scores Despite effect sizes being medium, risk factors cognitive functioning. In addition, impairment aggravates symptoms feelings.

Language: Английский

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Anästhesie in der Chirurgie des Herzens und der herznahen Gefäße

Springer Reference Medizin, Journal Year: 2025, Volume and Issue: unknown, P. 1 - 56

Published: Jan. 1, 2025

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Closing the care gap: combining enhanced recovery with minimally invasive valve surgery

Current Opinion in Cardiology, Journal Year: 2024, Volume and Issue: unknown

Published: April 9, 2024

Purpose of review Patients with advanced age and frailty require interventions for structural heart disease at an increasing rate. These patients typically experience higher rates postoperative morbidity, mortality prolonged hospital length stay, loss independence as well associated increased costs to the healthcare system. Therefore, it is becoming critically important raise awareness develop strategies improve clinical outcomes in contemporary, high-risk patient population undergoing cardiac procedures. Recent findings Percutaneous options have dramatically improved therapeutic some older, frail, patients; however, others may still surgery. Minimally invasive techniques can reduce physiologic burden experienced by surgery recovery. Enhanced Recovery After Cardiac Surgery (ERAS Cardiac) a comprehensive, interdisciplinary, evidence-based approach perioperative care. It has been shown recovery satisfaction while reducing complications stay. Summary Combining minimally enhanced protocols result high risk morbidity following

Language: Английский

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Thoracic sarcopenia measured by Hounsfield unit average calculation predicts morbidity and mortality in coronary artery bypass grafting

European Journal of Cardio-Thoracic Surgery, Journal Year: 2024, Volume and Issue: 66(2)

Published: Aug. 8, 2024

The aim of the study was to investigate potential prognostic role preoperative measurement erector spinae myosteatosis with Hounsfield unit average calculation as a marker for sarcopenia and frailty in patients undergoing coronary bypass surgery.

Language: Английский

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A good operation is not enough, when it comes to frail patients

European Journal of Cardio-Thoracic Surgery, Journal Year: 2023, Volume and Issue: 64(4)

Published: May 26, 2023

Journal Article A good operation is not enough, when it comes to frail patients Get access Nikolaos Bonaros, Bonaros Department of Cardiac Surgery, Medical University Innsbruck, Austria Corresponding author. Anichstrasse 35, 6020 Austria. Tel: +43-512-504-22501; fax: +43-512-504-22502; e-mail: [email protected] (N. Bonaros). https://orcid.org/0000-0002-7656-5812 Search for other works by this author on: Oxford Academic PubMed Google Scholar Emeline Van Craenenbroeck Heart Failure and Transplantation Unit, Antwerp Hospital, Antwerp, Belgium European Cardio-Thoracic Volume 64, Issue 4, October 2023, ezad205, https://doi.org/10.1093/ejcts/ezad205 Published: 26 May 2023 history Received: 16 Accepted: 24 Corrected typeset: 07

Language: Английский

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The Impact of Sarcopenia in the Long-Term Survival of Patients following Complex Endovascular Aortic Surgery for Thoracoabdominal Aortic Aneurysms

Diagnostics, Journal Year: 2024, Volume and Issue: 14(7), P. 751 - 751

Published: April 1, 2024

Objectives: Image-based sarcopenia has been the subject of recent studies, hypothesized as a prognostic factor for patients with thoracoabdominal aortic aneurysms. Methods and Materials: We conducted single-center retrospective analysis who underwent complex endovascular repair aneurysms between 2008 2016. CT image assessment was performed were classified sarcopenic non-sarcopenic using two stratification methods: skeletal mass index (SMI) total psoas muscle (TPMI). According to sex, each patient defined if their SMI or TPMI in lowest third study group. The primary endpoint impact on perioperative mortality long-term survival. Secondary endpoints complications. Results: From 155 patients, 135 eligible study. Overall, in-hospital 5.9% (8/135). 30-day, 1-year, 3-year 5-year 10.4% (14/135), 20% (27/135), 28.1% (38/135) 31.1% (42/135), respectively. There no difference rates regardless method used (p = 0.4 p 0.2 TPMI). SMI, 30-day significantly lower comparison (1/45, 2.2% vs. 13/90, 14.4%, 0.028). Based index, at higher risk development pulmonary complications postoperatively 0.03). Conclusion: Using TPMI, not associated reduced survival undergoing

Language: Английский

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Muskelrelaxierung bei geriatrischen Patient*innen

AINS - Anästhesiologie · Intensivmedizin · Notfallmedizin · Schmerztherapie, Journal Year: 2024, Volume and Issue: 59(09), P. 528 - 536

Published: Aug. 1, 2024

The administration of neuromuscular blocking agents has been used in anesthesia for decades and continues to play an important role modern anesthesia. Special patient populations, such as very young or old patients, require adapted use. following article discusses the specifics geriatric patients.

Language: Английский

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