Effect of transcatheter aortic valve implantation on health-related quality of life in older adults with multimorbidity

Abstract

Purpose: The purpose of this study was to determine the effect of transcatheter aortic valve implantation on health-related quality of life in older adults with multimorbidity and to evaluate the predictive factors for postoperative quality of life impairment in such patients.

Material and method: This study included 141 older adults with severe aortic stenosis scheduled for elective transcatheter aortic valve implantation. Quality of life was examined in all patients using the Short-Form 36 Health Survey Questionnaire, before and 2 years after surgery. Comorbidity was assessed using the Charlson Comorbidity Index.

Results: In older adult patients with aortic stenosis and multimorbidity, transcatheter aortic valve implantation significantly improved both physical and mental components of quality of life 2 years after surgery. A Charlson Comorbidity Index ≥5 points was independently associated with the absence of positive dynamics in Physical Health score [odds ratio (OR) 0.38 (0.20-0.75), p = 0.007]. Charlson Comorbidity Index ≥5 points [OR 0.31 (0.19-0.58), p = 0.026] and new-onset arrhythmia [OR 0.54 (0.38-0.78), p = 0.017] were independent predictors of the absence of positive dynamics in Mental Health score after transcatheter aortic valve implantation.

Conclusions: High-level comorbidity (Charlson Comorbidity Index ≥5 points) predicts both Physical and Mental Health scores for quality of life impairment following transcatheter aortic valve implantation in older adults, and new-onset arrhythmia predicts the Mental Health score for quality of life impairment following transcatheter aortic valve implantation in these patients.

Keywords: Aortic stenosis; Charlson Comorbidity Index; Quality of life; Transcatheter aortic valve implantation.