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Changes in the nutritional and activity status of elderly patients within 6 months of transcatheter aortic valve replacement: A mixed methods approach
Author(s) -
Okugawa Saki,
Shimizu Hideyuki,
Hayashida Kentaro,
Kawamoto Yuko,
Tanaka Makoto
Publication year - 2020
Publication title -
japan journal of nursing science
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.363
H-Index - 17
eISSN - 1742-7924
pISSN - 1742-7932
DOI - 10.1111/jjns.12305
Subject(s) - medicine , valve replacement , confidence interval , odds ratio , malnutrition , national health and nutrition examination survey , prospective cohort study , physical therapy , stenosis , gerontology , population , environmental health
Abstract Aim Our aim was to explore changes in nutritional and activity status of patients within 6 months after transcatheter aortic valve replacement (TAVR) and factors affecting malnutrition post‐TAVR in this cohort, and to gain understanding of their lifestyle considerations. Methods Using a mixed methods approach, we conducted a prospective, longitudinal survey, consisting of interviews and a questionnaire, of 50 participants aged ≥70 years (mean age, 83 years; 58.0% female) undergoing TAVR. Mini Nutritional Assessment (MNA) and albumin level (to measure nutritional status) and Physical Component Summary (PCS) scores from the 36‐item Short Form Health Survey (to measure activity status) were collected at pre‐TAVR and 1 month and 6 months post‐TAVR. Laboratory data and some index scores (e.g., the Clinical Frailty Scale [CFS] and the Mini‐Mental State Examination [MMSE]) assessed before TAVR were collected from medical records as related factors. Results Significant change was observed only in the MNA scores of participants who were assessed as malnourished at pre‐TAVR, which improved, but did not reach normal nutritional status. Low‐flow low‐gradient aortic stenosis (odds ratio [OR]: 166.39, 95% confidence interval [CI]: 5.43–5094.43), higher CFS scores (OR: 2.58, 95% CI: 1.01–6.54), and lower MMSE scores (OR: 0.65, 95% CI: 0.43–0.99) were related to malnutrition post‐TAVR. From interviews, three themes emerged: “balancing heart‐healthy lifestyle and longstanding habits,” “living with aging and disease” and “prospects for the rest of life.” Conclusions Our results could be utilized to identify patients at risk of malnutrition post‐TAVR, and to provide support with consideration of their lifestyle concerns.