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Frailty Predicts Adverse Outcomes After Mitral Valve Replacement

Index hospitalization costs almost doubled in frail patients and 30-day readmission more frequent

MONDAY, March 23, 2020 (HealthDay News) — For patients undergoing mitral valve replacement (MVR), frailty is an independent predictor of morbidity, death, and increased hospitalization costs, according to a study published online March 18 in the Annals of Thoracic Surgery.

Amit Iyengar, M.D., from the University of Pennsylvania in Philadelphia, and colleagues examined the influence of frailty on outcomes and readmission rates after MVR. Data were included for 50,410 adult patients undergoing isolated MVR from the National Readmissions Database from 2010 to 2014.

The researchers found that 7.9 percent of patients undergoing MVR met frailty criteria. Significantly more postoperative complications (77 versus 47 percent), discharges to a facility (50 versus 21 percent), and higher in-hospital mortality (12 versus 4 percent) were seen for frail patients. In frail patients, index hospitalization costs were almost doubled and 30-day readmissions were more frequent among those who survived to discharge (28 versus 20 percent). The risks for index hospitalization composite complications, in-hospital mortality, and 30-day readmission independently increased with frailty (adjusted odds ratios, 3.28, 2.35, and 1.47, respectively).

“Frailty is a hot topic and we feel confident that with further study and discussion among surgeons, we as a community can arrive at a consensus method for assessing frailty that could then be adopted widely,” Iyengar said in a statement.

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