Mobility aids predict mortality after transcatheter aortic valve implantation

Area of Science:

• Cardiology
• Geriatrics
• Medical Technology

Background:

• Patient selection for transcatheter aortic valve implantation (TAVI) is complex, with traditional scoring systems lacking predictive accuracy.
• Functional indices like mobility are crucial for assessing mortality risk, but are often subjectively measured.

Purpose of the Study:

• To objectively define the relationship between mobility, assessed by gait aid requirement, and mortality in TAVI patients.
• To evaluate mobility as a predictive index for both short-term (30-day) and long-term survival post-TAVI.

Main Methods:

• A cohort of 1444 TAVI patients was analyzed, categorizing mobility based on the Brighton Mobility Index (unaided, 1-stick, higher aid).
• Mortality data was tracked using the NHS Spine Portal.
• Statistical analysis correlated gait aid use with 30-day and long-term mortality rates.

Main Results:

• Overall 30-day mortality was 3.5% and 1-year mortality was 12.2%.
• Mobility aid use significantly predicted 30-day mortality (p=0.025), with higher aid use increasing mortality odds by 2.83.
• Mobility also significantly predicted long-term mortality (p<0.001), with odds ratios of 1.45 for 1-stick and 2.01 for higher aid.

Conclusions:

• Objective assessment of mobility via gait aid use is a significant predictor of survival in TAVI patients.
• Greater dependence on mobility aids correlates with a poorer prognosis, informing patient selection and risk stratification for TAVI.