Evidence map›Paper›PMID 36633679›Full record

Observational studyWiener klinische Wochenschrift2023

Frailty as a predictor of mortality and readmission rate in secondary mitral regurgitation.

Robert Uzel, Richard Rezar, Raphael Romano Bruno, Sarah Wernly, Christian Jung, Georg Delle Karth, Christian Datz, Friedrich Hoppichler, Bernhard Wernly

Open access · hybridAbstract readObservational Study
In one paragraph

Observational study in Wiener klinische Wochenschrift, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.2field-weighted citation impact, top 48% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 citations in OpenAlex.

  1. Review
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 4 institutions in 3 countries.

Robert UzelDepartment of Internal Medicine, Saint John of God Hospital, Teaching Hospital of the Paracelsus Medical Private University, Kajetanerplatz 1, 5020, Salzburg, Austria. robert.uzel@bbsalz.at.ORCID http://orcid.org/0000-0002-5125-3468
Richard RezarDepartment of Cardiology and Intensive Care Medicine, Paracelsus Medical University of Salzburg, Müllner Hauptstr. 48, 5020, Salzburg, Austria.
Raphael Romano BrunoDepartment of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, Heinrich-Heine-University Duesseldorf, Moorenstr. 5, 40225, Duesseldorf, Germany.
Sarah WernlyDepartment of Internal Medicine, General Hospital Oberndorf, Teaching Hospital of the Paracelsus Medical Private University, Paracelsusstr. 37, 5110, Oberndorf, Austria.
Christian JungDepartment of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, Heinrich-Heine-University Duesseldorf, Moorenstr. 5, 40225, Duesseldorf, Germany.
Georg Delle KarthDepartment of Cardiology, Klinik Floridsdorf, Brünner Str. 68, 1210, Vienna, Austria.
Christian DatzDepartment of Internal Medicine, General Hospital Oberndorf, Teaching Hospital of the Paracelsus Medical Private University, Paracelsusstr. 37, 5110, Oberndorf, Austria.
Friedrich HoppichlerDepartment of Internal Medicine, Saint John of God Hospital, Teaching Hospital of the Paracelsus Medical Private University, Kajetanerplatz 1, 5020, Salzburg, Austria.
Bernhard WernlyDepartment of Internal Medicine, General Hospital Oberndorf, Teaching Hospital of the Paracelsus Medical Private University, Paracelsusstr. 37, 5110, Oberndorf, Austria.
Paracelsus Medical University · ATHeinrich Heine University Düsseldorf · DEKrankenhaus Oberndorf · ATUniversity of Salzburg · AT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionSelection in patients with functional mitral regurgitation (MR) to identify responders to interventions is challenging. In these patients, frailty might be used as a multidimensional parameter to summarize the resilience to stressors. Our objective was to evaluate frailty as a predictor of outcome in patients with moderate to severe secondary MR.

methodsWe conducted a single-center retrospective observational cohort study and included 239 patients with moderate to severe secondary MR aged 65 years or older between 2014 and 2020. Echocardiography was performed at baseline; frailty was evaluated using the clinical frailty scale (CFS). The combined primary endpoint was hospitalization for heart failure and all-cause mortality.

resultsA total of 53% (127) of all patients were classified as CFS 4 (living with mild frailty) or higher. Frail patients had a higher risk for the combined endpoint (hazard ratio, HR 3.70, 95% confidence interval, CI 2.12-6.47; p < 0.001), 1‑year mortality (HR 5.94, 95% CI 1.76-20.08; p < 0.001) even after adjustment for EuroSCORE2. The CFS was predictive for the combined endpoint (AUC 0.69, 95% CI 0.62-0.75) and outperformed EuroSCORE2 (AUC 0.54, 95% CI 0.46-0.62; p = 0.01). In sensitivity analyses, we found that frailty was associated with adverse outcomes at least in trend in all subgroups.

conclusionFor older, medically treated patients with moderate to severe secondary mitral regurgitation, frailty is an independent predictor for the occurrence of death and heart failure-related readmission within 1 year and outperformed the EuroSCORE2. Frailty should be assessed routinely in patients with heart failure to guide clinical decision making for mitral valve interventions or conservative treatment.

Indexed as

FrailtyHeart FailureHeart Valve Prosthesis ImplantationMitral Valve InsufficiencyHumansPatient ReadmissionRetrospective StudiesTreatment OutcomeConservative treatmentDecision makingHeart failureMitral valve insufficiencyPrognosis

Identifiers

PMID36633679
PMCPMC9836337
OpenAlexW4315754400

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.