Introduction
Methods
Results
Baseline characteristics
Frail (n = 107) | Non-frail (n = 122) | p value | |
---|---|---|---|
Baseline | |||
Age, years | 79 ± 7 | 77 ± 9 | 0.02 |
Male, n (%) | 52 (49) | 74 (61) | 0.07 |
BMI (kg/m2) | 25.6 ± 5.7 | 25.2 ± 5.6 | 0.45 |
Logistic Euroscore | 22.1 ± 15.3 | 19.2 ± 15.2 | 0.09 |
Euroscore II | 9.2 ± 7 | 7.4 ± 6.6 | 0.008 |
Secondary MR aetiology, n (%) | 59 (55) | 72 (59) | 0.83 |
Hypertension, n (%) | 80 (75) | 89 (73) | 0.76 |
Diabetes mellitus, n (%) | 35 (33) | 27 (22) | 0.07 |
Previous stroke/TIA, n (%) | 13 (12) | 17 (14) | 0.69 |
Previous myocardial infarction, n (%) | 33 (31) | 35 (29) | 0.72 |
Coronary artery disease, n (%) | 65 (61) | 73 (60) | 0.89 |
Previous cardiac surgery, n (%) | 30 (28) | 54 (44) | 0.01 |
Previous ICD, n (%) | 16 (15) | 27 (22) | 0.17 |
Previous CRT, n (%) | 24 (22) | 21 (17) | 0.32 |
PAOD, n (%) | 13 (12) | 13 (11) | 0.72 |
COPD, n (%) | 19 (18) | 18 (15) | 0.52 |
Atrial fibrillation, n (%) | 70 (65) | 68 (56) | 0.14 |
Malignancy, n (%) | 16 (15) | 21 (17) | 0.64 |
GFR (ml/min/1.73m2) | 41.6 ± 20 | 51.2 ± 20 | 0.001 |
EF > 50%, n (%) | 56 (52) | 54 (44) | 0.4 |
NYHA, n (%) | < 0.001 | ||
I/II | 5 (5) | 24 (20) | |
III/IV | 102 (95) | 98 (80) | |
Frailty by IADL disability | 71 (66.4%) | 40 (32.8%) | < 0.001 |
Urgent referral status, n (%) | 18 (17) | 10 (8) | 0.047 |
Total length of stay (days) | 11.8 ± 9.7 | 8.2 ± 9.9 | < 0.001 |
Stay on regular ward | 8.0 ± 7.3 | 6.2 ± 8.7 | 0.03 |
Stay on intensive/intermediate care unit | 3.8 ± 5.7 | 2.1 ± 1.7 | < 0.001 |
Costs and revenues
Hospital costs (€) | Frail (n = 107) | Non-frail (n = 122) | p value |
---|---|---|---|
Total costs | 28,225 (26,832–31,756) [30,712 ± 7,754] | 27,459 (26,457–28,377) [28,240 ± 4,467] | 0.002 |
Total costs minus implant costs | 7,337 (5,911–9,814) [9,449 ± 7,188] | 6,238 (5,584–7,499) [7,132 ± 4,344] | 0.001 |
Regular ward | 1,670 (1,135–2,543) [2,258 ± 1,902] | 1,404 (980–1,843) [1,746 ± 2,274] | 0.011 |
Intermediate/intensive care unit | 1,401 (863–2,468) [2,973 ± 5,057] | 1,294 (746–1,459) [1,438 ± 1,269] | 0.001 |
Anaesthesia | 570 (457–706) [605 ± 368] | 568 (463–727) [600 ± 192] | 0.671 |
Cardiac catheter laboratorya | 23,931 (22,935–24,403) [23,867 ± 1,700] | 23,821 (23,185–24,450) [23,867 ± 1,222] | 0.931 |
Radiology | 28 (13–75) [90 ± 154] | 26 (0–50) [97 ± 230] | 0.049 |
Clinical chemistry | 223 (161–422) [385 ± 451] | 173 (140–239) [263 ± 302] | 0.002 |
Other diagnostics | 141 (93–288) [188 ± 134] | 108 (93–242) [160 ± 125] | 0.092 |
Physiotherapy | 31 (6–77) [101 ± 229] | 9 (0–35) [31 ± 58] | 0.034 |
Revenues | 31,959 (31,825–32,954) [32,964 ± 8,208] | 31,825 (31,638–32,834) [32,865 ± 10,185] | 0.034 |
Prolonged IMC/ICU stay
n = 38/107 frail patients | n = 23/122 non-frail patients | |
---|---|---|
MVARC major or minor bleeding | 14 (13.1%) | 7 (5.7%) |
Acute kidney injury requiring haemodialysis | 3 (2.8%) | 0 (0%) |
Infection | 4 (3.7%) | 2 (1.6%) |
Haemodynamic instability/arrhythmias | 6 (5.6%) | 5 (4.1%) |
Respiratory failure | 4 (3.7%) | 4 (3.3%) |
Logistics/other | 7 (6.5%) | 5 (4.1%) |