Association between frailty and self-reported health following heart valve surgery

Britt Borregaard, Jordi S. Dahl, Sandra B. Lauck, Jesper Ryg, Selina K. Berg, Ola Ekholm, Jeroen M. Hendriks, Lars P.S. Riber, Tone M. Norekvål, Jacob E. Møller

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Knowledge about the association between frailty and self-reported health among patients undergoing heart valve surgery remains sparse. Thus, the objectives were to I) describe changes in self-reported health at different time points according to frailty status, and to II) investigate the association between frailty status at discharge and poor self-reported health four weeks after discharge among patients undergoing heart valve surgery. Methods: In a prospective cohort study, consecutive patients undergoing heart valve surgery, including transapical/transaortic valve procedures were included. Frailty was measured using the Fried score, and self-reported health using the Kansas City Cardiomyopathy Questionnaire (KCCQ) and the EuroQoL-5 Dimensions 5-Levels Health Status Questionnaire (EQ-5D-5L). To investigate the association between frailty and self-reported health, multivariable logistic regression models were used. Analyses were adjusted for sex, age, surgical risk evaluation (EuroScore) and procedure and presented as odds ratios (OR) with 95% confidence intervals (CI). Results: Frailty was assessed at discharge in 288 patients (median age 71, 69% men); 51 patients (18%) were frail. In the multivariable analyses, frailty at discharge remained significantly associated with poor self-reported health at four weeks, OR (95% CI): EQ-5D-5L Index 3.38 (1.51–7.52), VAS 2.41 (1.13–5.14), and KCCQ 2.84 (1.35–5.97). Conclusion: Frailty is present at discharge in 18% of patients undergoing heart valve surgery, and being frail is associated with poor self-reported health at four weeks of follow-up. This supports a clinical need to address the unique risk of frail patients among heart valve teams broadly, and not only to measure frailty as a marker of operative risk.

Original languageEnglish
Article number100671
Number of pages8
JournalIJC Heart and Vasculature
Volume31
DOIs
Publication statusPublished - Dec 2020

Bibliographical note

Funding Information:
Thank you to the patients for participating in the study and to Siri Rosenkilde and Louise Stougaard for helping with the frailty assessments in the sub-study. Also, we thank the following foundations for their contributions: Helsefonden, The Odense University Hospital PhD Foundation, Ove William Buhl Olesen Foundation, and Kurt B?n.

Publisher Copyright:
© 2020 The Authors

Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.

Keywords

  • Cardiac surgery
  • Frailty
  • Health-related quality of life
  • Heart valves

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