Frailty Assessment Before Cardiac Surgery & Transcatheter Interventions
Overview
- Phase
- N/A
- Intervention
- Not specified
- Conditions
- Aortic Stenosis
- Sponsor
- Jewish General Hospital
- Enrollment
- 800
- Locations
- 14
- Primary Endpoint
- Post-procedural mortality or major morbidity
- Status
- Completed
- Last Updated
- 9 years ago
Overview
Brief Summary
Frailty is a state of decreased physiologic reserves and vulnerability to stressors. Several tools exist to measure frailty, some based on physical tests and others on questionnaires, yet there is no agreement on which tool to recommend. This multi-center prospective cohort study is aimed at comparing various frailty assessment tools to determine which best predicts death or major complications after cardiac surgery or transcatheter intervention. The population of interest is elderly patients with severe aortic stenosis undergoing surgical or transcatheter aortic valve replacement. The frailty assessment tools under investigation include composite frailty scales, physical performance tests, muscle mass, and biomarker expression. The overall objective is to improve our ability to predict risk by measuring frailty using the optimal tool in elderly cardiovascular patients.
Investigators
Jonathan Afilalo
MD MSc FACC FRCPC
Jewish General Hospital
Eligibility Criteria
Inclusion Criteria
- •Age ≥70 years (a site-specific substudy at the JGH will enroll ages ≥21 years)
- •Referred for surgical or transcatheter AVR (with or without concomitant revascularization)
- •Signed informed consent
Exclusion Criteria
- •Emergency surgery
- •Clinical instability: decompensated heart failure, active ischemia, unstable vital signs
- •Severe neuropsychiatric impairment
- •Not English or French speaking
- •Replacement of \>1 valve or aortic surgery
Outcomes
Primary Outcomes
Post-procedural mortality or major morbidity
Time Frame: 30 days
Mortality is defined as death from any cause. Major morbidity is defined as an aggregate of the Society of Thoracic Surgeons (STS) and Valve Academic Research Consortium (VARC) composite endpoints. Additionally, the individual components of this composite endpoint will be examined.
Secondary Outcomes
- All-cause mortality(6-12 months)
- Length of stay(30 days)
- Functional status(6-12 months)