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- Title
Functional capacity and health-related quality of life outcomes post transcatheter aortic valve replacement: a systematic review and meta-analysis.
- Authors
STRAITON, NICOLA; KAI JIN; BHINDI, RAVINAY; GALLAGHER, ROBYN
- Abstract
Background: transcatheter aortic valve replacement (TAVR) provides prognostic benefit for high surgical-risk patients with severe aortic stenosis (AS), yet the impact to patient outcomes is far less understood. Method: we performed a systematic review and meta-analysis to evaluate functional capacity and health-related quality of life (HRQoL) outcomes for patients up to 12 months post TAVR. A total of 20 eligible publications, comprising randomised-controlled trials, observational studies and a registry study were identified from electronic databases, including MEDLINE, EMBASE, Cochrane Library and others (inception to February 2017). Results: the total sample was 2,775 with a mean age of 81.8 ± 2.1 years, more than half (52%) were female and high surgical risk 9.6 ± 4.3% mean STS (Society of Thoracic Surgeons risk model). Post TAVR, patients had significant improvement in functional capacity of >40 m in the 6-minute walk test (6MWT) (95% confidence interval (CI) 9.69-73.28) and a clinically meaningful increase in ability to perform daily physical-based tasks (Duke Activity Status Index (DASI), mean difference (MD) increase 5.42 points, 95% CI 3.16-7.68). HRQoL improved consistently following TAVR regardless of measure used. Significant increases occurred in the physical component summary scores (PCS) of the short form (SF) health surveys (MD increase 10.45 (SF36) and 10.14 (SF12) points). Conclusion: functional capacity and HRQoL improved substantially following TAVR, despite evolving patient selection criteria, thus TAVR continues to provide a directly beneficial option for severe AS patients.
- Subjects
GERIATRIC assessment; AORTIC stenosis; BIOLOGICAL models; CONFIDENCE intervals; EXERCISE tests; HEALTH surveys; PROSTHETIC heart valves; INFORMATION storage &; retrieval systems; MEDICAL databases; MEDICAL information storage &; retrieval systems; MEDLINE; META-analysis; POSTOPERATIVE period; QUALITY of life; WALKING; SYSTEMATIC reviews; TREATMENT effectiveness; PSYCHOLOGY
- Publication
Age & Ageing, 2018, Vol 47, Issue 3, p478
- ISSN
0002-0729
- Publication type
Article
- DOI
10.1093/ageing/afx203