Objective In recent years, transcatheter aortic valve implantation (TAVI) has become the treatment of choice for patients with symptomatic aortic valve stenosis considered to be at increased or high surgical risk. The aim of this study was to identify predictors of postoperative adverse events in older adults undergoing TAVI. Methods A prospective observational cohort study of patients who were referred to a geriatric outpatient clinic for a geriatric assessment prior to TAVI was conducted. The outcomes were mortality and hospital readmission within 3 months of TAVI and the occurrence of major postoperative complications during hospitalisation according to the Clavien-Dindo classification. These three outcomes were also combined to a composite outcome. Univariate and multivariate logistic regression analyses were performed to identify predictors of the outcomes and composite outcome of adverse events. Results This cohort included 490 patients who underwent TAVI (mean age 80.7±6.2 years, 47.3% male). Within 3 months of TAVI, 19 (3.9%) patients died and 46 (9.4%) patients experienced a hospital readmission. A total of 177 (36.1%) patients experienced one or more major complications according to the Clavien-Dindo classification during hospitalisation and 193 patients (39.4%) experienced the composite outcome of adverse events. In multivariate analyses, cognitive impairment was identified as an independent predictor of major postoperative complications (OR 2.16; 95% CI 1.14 to 4.19) and the composite outcome of adverse events (OR 2.40; 95% CI 1.21 to 4.79). No association was found between the other variables and the separate outcomes and composite outcome. Conclusion Cognitive impairment is associated with postoperative adverse events in older patients undergoing TAVI. Therefore, it is important to screen for cognitive impairment prior to TAVI and it is recommended to include this in current TAVI guidelines. Data are available upon reasonable request. The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.

中文翻译：

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经导管主动脉瓣植入术后临床结果的预测因素：一项前瞻性队列研究

目的近年来，经导管主动脉瓣植入术（TAVI）已成为有症状的主动脉瓣狭窄患者手术风险增加或手术风险高的首选治疗方法。本研究的目的是确定接受 TAVI 的老年人术后不良事件的预测因素。方法 对在 TAVI 之前被转诊到老年科门诊进行老年科评估的患者进行了一项前瞻性观察性队列研究。根据 Clavien-Dindo 分类，结果是 TAVI 后 3 个月内的死亡率和再入院率以及住院期间主要术后并发症的发生率。这三个结果也被合并为一个复合结果。进行单变量和多变量逻辑回归分析以确定不良事件的结果和复合结果的预测因子。结果 该队列包括 490 名接受 TAVI 的患者（平均年龄 80.7±6.2 岁，47.3% 为男性）。在 TAVI 的 3 个月内，19 名 (3.9%) 患者死亡，46 名 (9.4%) 患者再次入院。根据 Clavien-Dindo 分类，共有 177 名 (36.1%) 患者在住院期间经历了一种或多种主要并发症，193 名患者 (39.4%) 经历了不良事件的复合结果。在多变量分析中，认知障碍被确定为主要术后并发症（OR 2.16；95% CI 1.14 至 4.19）和不良事件复合结果（OR 2.40；95% CI 1.21 至 4.79）的独立预测因子。未发现其他变量与单独结局和复合结局之间存在关联。结论 在接受 TAVI 的老年患者中，认知障碍与术后不良事件相关。因此，在 TAVI 之前筛查认知障碍很重要，建议将其纳入当前的 TAVI 指南。可应合理要求提供数据。当前研究中使用和/或分析的数据集可根据合理要求从相应的作者处获得。可应合理要求提供数据。当前研究中使用和/或分析的数据集可根据合理要求从相应的作者处获得。可应合理要求提供数据。当前研究中使用和/或分析的数据集可根据合理要求从相应的作者处获得。