Changes in the nutritional and activity status of elderly patients within 6 months of transcatheter aortic valve replacement: A mixed methods approach.

Abstract

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. 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. 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." Our results could be utilized to identify patients at risk of malnutrition post-TAVR, and to provide support with consideration of their lifestyle concerns.