{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T11:06:58Z","timestamp":1770894418225,"version":"3.50.1"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2019,4,11]],"date-time":"2019-04-11T00:00:00Z","timestamp":1554940800000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]},{"name":"C\/Sinesio Delgado 4","award":["PI11\/00640"],"award-info":[{"award-number":["PI11\/00640"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p\/>\n               <jats:sec>\n                  <jats:title>OBJECTIVES<\/jats:title>\n                  <jats:p>Frailty syndrome predicts adverse outcomes after surgical aortic valve replacement. However, disability or comorbidity is frequently associated with preoperative frailty evaluation. The effects of these domains on early and late outcomes were analysed.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>A prospective study including patients aged \u226575\u2009years with symptomatic severe aortic stenosis who received aortic valve replacement with or without coronary artery bypass grafting was conducted. We used the Cardiovascular Health Study Frailty Phenotype to assess frailty, the Lawton\u2013Brody index to define disability and the Charlson comorbidity index (CCI) to evaluate comorbidity.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>Frailty was identified in 57 (31%), dependence in 18 (9.9%) and advanced comorbidity (CCI \u2265 4) in 67 (36.6%) of the 183 enrolled patients. Operative mortality (1.6%), transfusion rate and duration of stay increased in patients with CCI \u22654 (P\u2009&lt;\u20090.005). There was a non-significant trend for these adverse outcomes among the frail patients. Follow-up was achieved in all patients (median\/interquartile range 869\/699\u20131099\u2009days). Kaplan\u2013Meier univariable analysis showed a reduced survival rate for frail and dependent patients and for those with multiple comorbidities (P\u2009&lt;\u20090.05). According to multivariable analysis, frailty and comorbidity were independent risk factors for 1-year mortality, while disability and comorbidity, but not frailty, were risk factors for 3-year mortality (P\u2009&lt;\u20090.05).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>Surgical aortic valve replacement in patients aged \u226575\u2009years is a safe procedure with low mortality rates. Operative outcomes are mainly affected by comorbidities. The main influence of survival occurs throughout the first year, and an improved functional status prevents any progression towards disabilities, which could potentially benefit long-term outcomes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Clinical trial registration number<\/jats:title>\n                  <jats:p>NCT02745314<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/icvts\/ivz093","type":"journal-article","created":{"date-parts":[[2019,3,15]],"date-time":"2019-03-15T08:08:19Z","timestamp":1552637299000},"page":"371-377","source":"Crossref","is-referenced-by-count":20,"title":["Frailty, disability and comorbidity: different domains lead to different effects after surgical aortic valve replacement in elderly patients"],"prefix":"10.1093","volume":"29","author":[{"given":"Miguel","family":"Pi\u00f1\u00f3n","sequence":"first","affiliation":[{"name":"Department of Cardiac Surgery, Complejo Hospitalario Universitario de Vigo, Vigo, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emilio","family":"Paredes","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Complejo Hospitalario Universitario de Vigo, Vigo, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Beatriz","family":"Acu\u00f1a","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Complejo Hospitalario Universitario de Vigo, Vigo, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sergio","family":"Raposeiras","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Complejo Hospitalario Universitario de Vigo, Vigo, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elena","family":"Casquero","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Complejo Hospitalario Universitario de Vigo, Vigo, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana","family":"Ferrero","sequence":"additional","affiliation":[{"name":"Department of Geriatric Medicine, Complejo Hospitalario Universitario de Vigo, Vigo, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ivett","family":"Torres","sequence":"additional","affiliation":[{"name":"Department of Geriatric Medicine, Complejo Hospitalario Universitario de Vigo, Vigo, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juan Jos\u00e9","family":"Legarra","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Complejo Hospitalario Universitario de Vigo, Vigo, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gonzalo","family":"Pradas","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Complejo Hospitalario Universitario de Vigo, Vigo, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francisco","family":"Barreiro-Morandeira","sequence":"additional","affiliation":[{"name":"Department of Surgery, Universidad de Santiago de Compostela, Santiago de Compostela, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlos","family":"Rodriguez-Pascual","sequence":"additional","affiliation":[{"name":"Department of Geriatric Medicine, Complejo Hospitalario Universitario de Vigo, Vigo, Spain"},{"name":"University of Lincoln, Lincoln, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2019,4,10]]},"reference":[{"key":"2019091011515798500_ivz093-B1","doi-asserted-by":"crossref","first-page":"1002","DOI":"10.1016\/j.jacc.2013.05.015","article-title":"Aortic stenosis in the elderly: disease prevalence and number of candidates for transcatheter aortic valve replacement: a meta-analysis and modeling study","volume":"62","author":"Osnabrugge","year":"2013","journal-title":"J Am Coll Cardiol"},{"key":"2019091011515798500_ivz093-B2","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1161\/01.CIR.38.1S5.V-61","article-title":"Aortic stenosis","volume":"38","author":"Ross","year":"1968","journal-title":"Circulation"},{"key":"2019091011515798500_ivz093-B3","doi-asserted-by":"crossref","first-page":"1105","DOI":"10.1161\/01.CIR.66.5.1105","article-title":"The effect of aortic valve replacement on survival","volume":"66","author":"Schwarz","year":"1982","journal-title":"Circulation"},{"key":"2019091011515798500_ivz093-B4","doi-asserted-by":"crossref","first-page":"616","DOI":"10.1093\/ejcts\/ezx324","article-title":"2017 ESC\/EACTS Guidelines for the management of valvular heart disease. 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