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Heart Lung and Circulation
Article . 2019
License: Elsevier TDM
Data sources: Crossref
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The Influence of the Charlson Comorbidity Index on Procedural Characteristics, VARC-2 Endpoints and 30-Day Mortality Among Patients Who Undergo Transcatheter Aortic Valve Implantation

Authors: Sudhakar George; Chun Shing Kwok; Glen P. Martin; Aswin Babu; Adrian Shufflebotham; James Nolan; Karim Ratib; +3 Authors

The Influence of the Charlson Comorbidity Index on Procedural Characteristics, VARC-2 Endpoints and 30-Day Mortality Among Patients Who Undergo Transcatheter Aortic Valve Implantation

Abstract

Background Aortic stenosis (AS) is a common valvular abnormality and transcatheter aortic valve implantation (TAVI) is being increasingly used to treat patients considered too high risk for conventional surgery. We aimed to assess the prevalence of comorbid conditions in patients undergoing TAVI using the Charlson Comorbidity Index (CCI) and to assess their impact on clinical and procedural outcomes. Methods We analysed 158 patients who underwent a TAVI at our institution between June 2009 and September 2015 to define their co-morbid burden as measured with CCI, and study its impact on procedural characteristics and mortality at 30 days. Results One hundred fifty-eight (158) patients with a mean age of 82 ± 8 years and a mean CCI score of 2.67 underwent a TAVI. Only 12/158 patients had a CCI of 0. The commonest cardiovascular comorbidities were previous myocardial infarction (24%), congestive heart failure (15%) and diabetes mellitus (23%) whilst the commonest non-cardiovascular comorbidities were renal disease (46%) and chronic obstructive pulmonary disease (COPD) (29%). After multivariable adjustment, CCI was not independently associated with adverse clinical outcomes. The addition of CCI to scoring systems such as Logistic EuroScore (LES) and Society of Thoracic Surgeons (STS) risk models improved the area under the curve from 0.75 (95%CI: 0.44–1.00) and 0.83 (95%CI: 0.64–1.00) to 0.78 (95%CI: 0.53–1.00) and 0.89 (95%CI: 0.78–1.00) respectively. Conclusions The burden of comorbid conditions in patients undergoing TAVI is significant. The CCI score was not independently associated with a higher risk of death but can be useful in addition to LES and STS risk models in informing decision making on the selection of patients for TAVI.

Country
United Kingdom
Subjects by Vocabulary

Microsoft Academic Graph classification: medicine.medical_specialty Transcatheter aortic Disease Internal medicine Diabetes mellitus Medicine Myocardial infarction COPD business.industry Area under the curve medicine.disease Stenosis Heart failure Cardiology business

Keywords

Male, Pulmonary and Respiratory Medicine, Time Factors, Comorbidity, Transcatheter Aortic Valve Replacement, Pulmonary Disease, Chronic Obstructive, transcatheter valve implantation, Risk Factors, Humans, health care outcomes, Aged, Aged, 80 and over, Aortic Valve Stenosis, aortic valve disease, RC666, R1, Female, Kidney Diseases, Cardiology and Cardiovascular Medicine

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    This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
    9
    popularity
    This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
    Top 10%
    influence
    This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
    Average
    impulse
    This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
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download
citations
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
views
OpenAIRE UsageCountsViews provided by UsageCounts
downloads
OpenAIRE UsageCountsDownloads provided by UsageCounts
9
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53
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