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  • 1
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    Remote symptom monitoring after hospital discharge.
    American Society of Clinical Oncology (ASCO) ; 2022
    In:  Journal of Clinical Oncology Vol. 40, No. 16_suppl ( 2022-06-01), p. 1517-1517
    Details
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 40, No. 16_suppl ( 2022-06-01), p. 1517-1517
    Abstract: 1517 Background: Strategies to improve transitions from the hospital to home for patients with cancer are considered an important component of quality, patient-centered care in oncology. CMS evaluates cancer hospital performance based on the 30-day unplanned hospital readmission rate, and this measure has been endorsed by the National Quality Forum. Nationally, the 30-day readmission rate for oncology patients ranges from 19%-27%. These readmissions come at high psychosocial, physical, and financial costs for patients and caregivers. A remote monitoring intervention that includes frequent contacts with the patient is likely to be effective in improving this transition. Methods: We evaluated the feasibility, acceptability, and perceived value of a mobile health intervention to monitor and manage symptoms of adult medical and surgical oncology patients discharged from an NCI-designated cancer center to home. Patients were monitored for 10 days, which is the median time to readmission for an oncology patient. The technology supporting the program included: 1) a patient portal enabling daily electronic patient-reported outcomes assessments; 2) a pulse oximeter to provide data on blood oxygen level and heart rate; 3) alerts for concerning symptoms; 4) an application to allow staff to review and trend symptom data; 5) a secure platform to support communications and televisits between staff and patients; 6) an advanced feedback report to provide just-in-time patient symptom education. Feasibility and acceptability were evaluated through engagement (goal: 〉 50% response rate) and symptom alerts and perceived value was measured through a patient engagement survey that included a net promoter score (how likely the patient is to recommend the program to similar patients; goal 〉 0.7). Results: Between September 27, 2020 to December 31, 2021, the program enrolled 1,091 medical oncology (median age: 63 years, 55% female) and 4,222 surgical oncology patients (median age: 63 years,55% female). Of those enrolled, 65% of medical and 74% of surgical oncology patients participated in home remote monitoring by self-reporting symptom data. This resulted in 2,869 completed symptom assessment from medical and 16,009 completed assessments from surgical patients. Sixty-three percent of medical oncology assessments resulted in a yellow (moderate) or red (severe) symptom alert compared with 26% for surgical oncology patients. Pain was the predominant symptom generating red alerts for medical oncology patients (17%). Fifty-two percent of patients completed the engagement survey, and the net promoter score was 0.82. Conclusions: A remote monitoring program after discharge was feasible, acceptable, and perceived to be of value by oncology patients discharged from a cancer center. Surgical and medical patients have similar response rates but differ in symptom burden. Future work will evaluate the value of a remote symptom monitoring platform in decreasing readmissions.
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    URL: Article
    DOI: 10.1200/JCO.2022.40.16_suppl.1517
    RVK:
    XA 52760
    RVK:
    XA 10000
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2022
    detail.hit.zdb_id: 2005181-5
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  • 2
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    Use of remote patient monitoring in the care of COVID-positive patients in oncology.
    American Society of Clinical Oncology (ASCO) ; 2021
    In:  Journal of Clinical Oncology Vol. 39, No. 15_suppl ( 2021-05-20), p. 1554-1554
    Details
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 39, No. 15_suppl ( 2021-05-20), p. 1554-1554
    Abstract: 1554 Background: Cancer patients face an increased risk of developing acute complications from COVID-19. Remote monitoring can help with the critical need for early detection of symptoms among those diagnosed with COVID-19, enabling timely symptom management that can mitigate clinical deterioration. In response to this need, Memorial Sloan Kettering Cancer Center fast-tracked a program to monitor patients with COVID-19 from home, using an electronic symptom-tracking questionnaire and digital pulse oximeter to track patients’ status and alert care teams to intervene if symptoms worsened. A multi-disciplinary group composed of Oncology providers, advanced practice providers, nursing, nursing informatics and biomedical informatics formed to manage the program. Methods: Memorial Sloan Kettering launched a remote monitoring program for patients diagnosed with COVID-19 on March 25, 2020. All patients testing positive for COVID-19 were enrolled in the program and asked to complete a daily symptom tracking questionnaire accessed through their patient portal or administered verbally over the phone. A subset of high risk patients were also provided with a digital pulse oximeter linked to their patient portal and capable of transmitting readings directly to the care team. Clinicians received alerts for patients reporting symptoms or an oxygen saturation below 92%. Alerts resulted in an immediate response from the care team to determine if the patient needed additional care. We retrospectively evaluated the program usage, outcomes and learnings from March 25, 2020 to December 22, 2020. Results: In total, 1,721 patients were enrolled in the program from March 25, 2020 to December 22, 2020. Among these, 210 were deemed high risk patients who received a pulse oximeter in addition the daily symptom questionnaire. Over this period, 27% of patients triggered an alert from an electronic symptom questionnaire, and 63% of patients with a pulse oximeter triggered an alert from their device. Among patients who triggered an alert of any kind, 3% were triaged to a higher level of care. Patients reported that the program was highly valued and alleviated anxiety about their care. Iterative improvements were made to the program over time in response to the evolving knowledge about care for patients with COVID-19. Conclusions: Memorial Sloan Kettering was able to quickly implement a program to detect and triage symptoms among patients with COVID-19 and cancer. Refinements were made over time to many aspects of the program in response to learnings about care related to COVID-19, including to clinical eligibility, alert criteria, monitoring duration and workflows. The program also demonstrated value for patients who felt more comfortable with their care while being monitored remotely. This program established a successful model for remote monitoring of patients with COVID-19 with the potential to be scaled to other institutions or clinical areas.
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    URL: Article
    DOI: 10.1200/JCO.2021.39.15_suppl.1554
    RVK:
    XA 52760
    RVK:
    XA 10000
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2021
    detail.hit.zdb_id: 2005181-5
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  • 3
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    Oncology patients’ perspectives on remote patient monitoring for COVID-19.
    American Society of Clinical Oncology (ASCO) ; 2021
    In:  Journal of Clinical Oncology Vol. 39, No. 15_suppl ( 2021-05-20), p. 1504-1504
    Details
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 39, No. 15_suppl ( 2021-05-20), p. 1504-1504
    Abstract: 1504 Background: Oncology patients are particularly vulnerable to adverse outcomes from COVID-19 and require careful monitoring to identify early deterioration and render higher level care when indicated. Several institutions launched remote patient monitoring programs (RPMPs) to care for patients with COVID-19. We describe patients’ perspectives on a COVID-19 RPMP at a National Comprehensive Cancer Center. Methods: Adult patients who had either tested positive for COVID-19 on an outpatient microbiology test or were discharged after hospitalization for the virus were eligible. Patients enrolled in the RPMP received a daily 10-question electronic patient-reported outcome assessment of COVID-19 symptoms and their responses generated alerts to a centralized monitoring team for new or worsening symptoms. A subset of high-risk patients also received a pulse oximeter which alerted when blood oxygen levels dropped below 93%. RPM was discontinued 14 days after a patient’s positive test result and following 3 days without worsening symptoms or fever. Patients who exited the program and had completed at least one assessment were sent a patient engagement survey. The objective of the survey was to evaluate the patient’s experience with digital monitoring and symptom management for COVID-19. The assessment was structured with objective response questions, including a net promoter score, and free text questions to elicit patient perspectives on RPM value. Free text responses were analyzed using grounded theory to identify primary themes regarding perceived value. Results: The survey was distributed to 452 patients; 241 responded as of June 10, 2020 (53% completion rate). The net promoter score was 91%. The table provides responses to objective questions. Qualitative analysis of free text responses identified the primary themes regarding patient perceived value which included: 1) Security: patients appreciated that the RPMP provided a clinical safety net; 2) Connection: patients appreciated the link to their clinical team during a period of isolation; 3) Empowerment: patients appreciated that the RPMP provided education on the virus and symptom management. Conclusions: RPMPs are perceived to be of value to oncology patients with COVID-19. A key barrier to maintaining these programs is cost. Policymakers should consider how these programs can be reimbursed in the future so that they can continue to provide care to vulnerable patients and keep them at home out of the acute care setting.[Table: see text]
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    URL: Article
    DOI: 10.1200/JCO.2021.39.15_suppl.1504
    RVK:
    XA 52760
    RVK:
    XA 10000
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2021
    detail.hit.zdb_id: 2005181-5
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  • 4
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    Association between remote monitoring and acute care visits in high-risk patients initiating intravenous antineoplastic therapy.
    American Society of Clinical Oncology (ASCO) ; 2022
    In:  Journal of Clinical Oncology Vol. 40, No. 16_suppl ( 2022-06-01), p. 1578-1578
    Details
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 40, No. 16_suppl ( 2022-06-01), p. 1578-1578
    Abstract: 1578 Background: Acute care visits (emergency department [ED] visits or inpatient admissions) for patients with cancer are growing disproportionately. Traditional oncology care models have not effectively identified and managed at-risk patients to prevent acute care. A next step is to harness advances in technology and mobile applications to enable patients to report symptoms any time, enabling “digital hovering” - intensive monitoring and management of high-risk patients. Our objective was to evaluate a digital platform that identifies and remotely monitors high-risk patients initiating intravenous antineoplastic therapy with the goal of preventing unnecessary acute care visits. Methods: This was a single-institution matched cohort quality improvement study conducted at an NCI-designated cancer center between January 1, 2019 and March 31, 2020. Eligible patients were those initiating intravenous antineoplastic therapy who were identified as high-risk for seeking acute care. Patients were identified as high-risk for an acute care visit by their oncologist with decision support from a web-based machine learning model. Enrolled patients’ symptoms were monitored using a digital platform. The platform is integrated into the EMR and includes: 1) a secure patient portal enabling communication and daily delivery of electronic patient-reported outcomes symptom assessments; 2) clinical alerts for concerning symptoms; and 3) a symptom trending application. A dedicated team of registered nurses and nurse practitioners managed reported symptoms. These clinicians acted as an extension of the primary oncology team, assisting with patient management exclusively through the platform. The primary outcomes evaluated were incidence of ED visits and inpatient admissions within six months of intravenous antineoplastic initiation. Results: Eighty-one high-risk patients from the intervention arm were matched by stage and disease with contemporaneous high-risk control patients. Matched cohorts had similar baseline characteristics, including age, sex, race, and treatment. ED visits and hospitalizations within six months of treatment initiation were analyzed using cumulative incidence analyses with a competing risk of death. The cumulative incidence of an ED visit for the intervention cohort was 0.27 (95% CI: 0.17, 0.37) at six months compared to 0.47 (95% CI: 0.36, 0.58) in the control group (p = 0.01). The cumulative incidence of an inpatient admission was 0.23 (95% CI: 0.14, 0.33) in the intervention group versus 0.41 (95% CI: 0.30, 0.51) in the control group (p = 0.02). Conclusions: The narrow employment of technology solutions to complex care delivery challenges in oncology can improve outcomes and innovate care. This program was a first step in using a digital platform and a remote team to improve symptom care in the home for high-risk patients.
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    URL: Article
    DOI: 10.1200/JCO.2022.40.16_suppl.1578
    RVK:
    XA 52760
    RVK:
    XA 10000
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2022
    detail.hit.zdb_id: 2005181-5
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  • 5
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    Risk stratification and daily symptom monitoring for oncology patients.
    American Society of Clinical Oncology (ASCO) ; 2019
    In:  Journal of Clinical Oncology Vol. 37, No. 15_suppl ( 2019-05-20), p. 6535-6535
    Details
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 37, No. 15_suppl ( 2019-05-20), p. 6535-6535
    Abstract: 6535 Background: Monitoring and managing patient reported outcomes (PROs) has been recommended for oncology patients on active treatment but can be time and resource intensive. Identifying patients likely to benefit and the optimal frequency of PRO capture is still under investigation. We tested the feasibility of monitoring patients who are high-risk risk for acute care with daily PROs. Methods: Using data from our institution, we developed a model that employs over 400 clinical variables to calculate a patient’s risk of an emergency room visit within 6 months following the onset of treatment. From October 15, 2018 to January 23, 2019, we enrolled patients identified as high risk through a technology-enabled program to monitor and manage those patients’ symptoms. Enrolled patients entered PRO assessments daily via an online portal. Symptoms were monitored and managed by a centralized clinical team. Tiered notifications informed the team of concerning or escalating symptoms. We assessed how frequently patients completed symptom assessments and the frequency of symptom notifications. Results: During the pilot, 28 patients were identified as high risk and enrolled in the program (median age 65; 64% percent female). Disease types were: 15 (54%) thoracic, 7 (25%) gynecologic, 6 (21%) gastrointestinal. Median time in the program was 50 (6-98) days. Patients completed 840 of 1,350 assessments (62%). There were 328 assessments that triggered moderate alerts (39%) and 220 that triggered severe alerts (26%). The table describes the prevalence of symptoms at the patient-level. Conclusions: A model can be employed to identify high-risk patients in collaboration with clinicians. Our adherence rate with a daily symptom assessment was similar to those found in studies of less frequent PRO capture. Future work will expand to a larger patient population with other cancer types, evaluate impact on outcomes, and assess optimal frequency for PRO collection and alert thresholds. [Table: see text]
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    URL: Article
    DOI: 10.1200/JCO.2019.37.15_suppl.6535
    RVK:
    XA 52760
    RVK:
    XA 10000
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2019
    detail.hit.zdb_id: 2005181-5
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  • 6
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    A framework for building a clinically relevant risk model.
    American Society of Clinical Oncology (ASCO) ; 2019
    In:  Journal of Clinical Oncology Vol. 37, No. 15_suppl ( 2019-05-20), p. 6554-6554
    Details
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 37, No. 15_suppl ( 2019-05-20), p. 6554-6554
    Abstract: 6554 Background: Acute care accounts for half of cancer expenditures and is a measure of poor quality care. Identifying patients at high risk for emergency department (ED) visits enables institutions to target resources to those most likely to benefit. Risk stratification models developed to date have not been meaningfully employed in oncology, and there is a need for clinically relevant models to improve patient care. Methods: We established and applied a predictive framework for clinical use with attention to modeling technique, clinician feedback, and application metrics. The model employs electronic health record data from initial visit to first antineoplastic administration for patients at our institution from January 2014 to June 2017. The binary dependent variable is occurrence of an ED visit within the first 6 months of treatment. The final regularized multivariable logistic regression model was chosen based on clinical and statistical significance. In order to accommodate for the needs to the program, parameter selection and model calibration were optimized to suit the positive predictive value of the top 25% of observations as ranked by model-determined risk. Results: There are 5,752 antineoplastic administration starts in our training set, and 1,457 in our test set. The positive predictive value of this model for the top 25% riskiest new start antineoplastic patients is 0.53. From over 1,400 data features, the model was refined to include 400 clinically relevant ones spanning demographics, pathology, clinician notes, labs, medications, and psychosocial information. At the patient level, specific features determining risk are surfaced in a web application, RiskExplorer, to enable clinician review of individual patient risk. This physician facing application provides the individual risk score for the patient as well as their quartile of risk when compared to the population of new start antineoplastic patients. For the top quartile of patients, the risk for an ED visit within the first 6 months of treatment is greater than or equal to 49%. Conclusions: We have constructed a framework to build a clinically relevant risk model. We are now piloting it to identify those likely to benefit from a home-based, digital symptom management intervention.
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    URL: Article
    DOI: 10.1200/JCO.2019.37.15_suppl.6554
    RVK:
    XA 52760
    RVK:
    XA 10000
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2019
    detail.hit.zdb_id: 2005181-5
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  • 7
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    Pilot program of remote monitoring for high-risk patients on antineoplastic treatment.
    American Society of Clinical Oncology (ASCO) ; 2020
    In:  Journal of Clinical Oncology Vol. 38, No. 15_suppl ( 2020-05-20), p. 2027-2027
    Details
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 38, No. 15_suppl ( 2020-05-20), p. 2027-2027
    Abstract: 2027 Background: Early detection and management of symptoms in patients with cancer improves outcomes, however, the optimal approach to symptom monitoring and management is unknown. This pilot program uses a mobile health intervention to capture and make accessible symptom data for high-risk patients to mitigate symptom escalation. Methods: Patients initiating antineoplastic treatment at a Memorial Sloan Kettering regional location were eligible. A dedicated staff of RNs and nurse practitioners managed the patients remotely. The technology supporting the program included: 1) a predictive model that identified patients at high risk for a potentially preventable acute care visit; 2) a patient portal enabling daily ecological momentary assessments (EMA); 3) alerts for concerning symptoms; 4) an application that allowed staff to review and trend symptom data; and 5) a secure messaging platform to support communications and televisits between staff and patients. Feasibility and acceptability were evaluated through enrollment (goal ≥25% of new treatment starts) and response rates (completion of 〉 50% of daily symptom assessments); symptom alerts; perceived value based on qualitative interviews with patients and providers; and acute care usage. Results: Between October 15, 2018 and July 10, 2019, the pilot enrolled 100 high-risk patients with solid tumors and lymphoma initiating antineoplastic treatment (median age: 66 years, 45% female). This represented 29% of patients starting antineoplastics. Over six months of follow-up, the response rate to the daily assessments was 56% and 93% of patients generated a severe symptom alert (Table). Both patients and providers perceived value in the program and 5,010 symptom-related secure messages were shared between staff and enrolled patients during the follow-up period. There was a preliminary signal in acute care usage with a 17% decrease in ED visits compared to a cohort of high-risk unenrolled patients. Conclusions: This pilot program of intensive monitoring of high-risk patients is feasible and holds significant potential to improve patient care and decrease hospital resources. Future work should focus on the optimal cadence of EMAs, the workforce to support remote symptom management, and how best to return symptom data to patients and clinical teams. [Table: see text]
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    URL: Article
    DOI: 10.1200/JCO.2020.38.15_suppl.2027
    RVK:
    XA 52760
    RVK:
    XA 10000
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2020
    detail.hit.zdb_id: 2005181-5
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  • 8
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    Oncology Patients' Perspectives on Remote Patient Monitoring for COVID-19
    American Society of Clinical Oncology (ASCO) ; 2021
    In:  JCO Oncology Practice Vol. 17, No. 9 ( 2021-09), p. e1278-e1285
    Details
    In: JCO Oncology Practice, American Society of Clinical Oncology (ASCO), Vol. 17, No. 9 ( 2021-09), p. e1278-e1285
    Abstract: Oncology patients are vulnerable to adverse outcomes associated with COVID-19, and clinical deterioration must be identified early. Several institutions launched remote patient monitoring programs (RPMPs) to care for patients with COVID-19. We describe patients' perspectives on a COVID-19 RPMP at a National Comprehensive Cancer Center. METHODS: Patients who tested positive for COVID-19 were eligible. Enrolled patients received a daily electronic COVID-19 symptom assessment, and a subset of high-risk patients also received a pulse oximeter. Monitoring was provided by a centralized team and was discontinued 14 days after a patient's positive test result and following 3 days without worsening symptoms. Patients who completed at least one assessment and exited the program were sent a patient engagement survey to evaluate the patient's experience with digital monitoring for COVID-19. RESULTS: The survey was distributed to 491 patients, and 257 responded (52% completion rate). The net promoter score was 85%. Most patients agreed that the RPMP was worthwhile, enabled better management of their COVID-19 symptoms, made them feel more connected to their healthcare team, and helped prevent emergency room visits. Identified themes regarding patient-perceived value of a RPMP included (1) security: a clinical safety net; (2) connection: a link to their clinical team during a period of isolation; and (3) empowerment: an education on the virus and symptom management. CONCLUSION: RPMPs are perceived to be of value to oncology patients with COVID-19. Policymakers should consider how these programs can be reimbursed to keep vulnerable patients at home and out of the acute care setting.
    Type of Medium: Online Resource
    ISSN: 2688-1527 , 2688-1535
    URL: Article
    DOI: 10.1200/OP.21.00269
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2021
    detail.hit.zdb_id: 3005549-0
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  • 9
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    Self-expanding Transcatheter vs Surgical Aortic Valve Replacement in Intermediate-Risk Patients : 5-Year Outcomes of the SURTAVI Randomized Clinical Trial
    American Medical Association (AMA) ; 2022
    In:  JAMA Cardiology Vol. 7, No. 10 ( 2022-10-01), p. 1000-
    Details
    In: JAMA Cardiology, American Medical Association (AMA), Vol. 7, No. 10 ( 2022-10-01), p. 1000-
    Abstract: In patients with severe aortic valve stenosis at intermediate surgical risk, transcatheter aortic valve replacement (TAVR) with a self-expanding supra-annular valve was noninferior to surgery for all-cause mortality or disabling stroke at 2 years. Comparisons of longer-term clinical and hemodynamic outcomes in these patients are limited. Objective To report prespecified secondary 5-year outcomes from the Symptomatic Aortic Stenosis in Intermediate Risk Subjects Who Need Aortic Valve Replacement (SURTAVI) randomized clinical trial. Design, Setting, and Participants SURTAVI is a prospective randomized, unblinded clinical trial. Randomization was stratified by investigational site and need for revascularization determined by the local heart teams. Patients with severe aortic valve stenosis deemed to be at intermediate risk of 30-day surgical mortality were enrolled at 87 centers from June 19, 2012, to June 30, 2016, in Europe and North America. Analysis took place between August and October 2021. Intervention Patients were randomized to TAVR with a self-expanding, supra-annular transcatheter or a surgical bioprosthesis. Main Outcomes and Measures The prespecified secondary end points of death or disabling stroke and other adverse events and hemodynamic findings at 5 years. An independent clinical event committee adjudicated all serious adverse events and an independent echocardiographic core laboratory evaluated all echocardiograms at 5 years. Results A total of 1660 individuals underwent an attempted TAVR (n = 864) or surgical (n = 796) procedure. The mean (SD) age was 79.8 (6.2) years, 724 (43.6%) were female, and the mean (SD) Society of Thoracic Surgery Predicted Risk of Mortality score was 4.5% (1.6%). At 5 years, the rates of death or disabling stroke were similar (TAVR, 31.3% vs surgery, 30.8%; hazard ratio, 1.02 [95% CI, 0.85-1.22]; P  =   .85). Transprosthetic gradients remained lower (mean [SD], 8.6 [5.5] mm Hg vs 11.2 [6.0] mm Hg; P   & amp;lt; .001) and aortic valve areas were higher (mean [SD], 2.2 [0.7] cm 2 vs 1.8 [0.6] cm 2 ; P   & amp;lt; .001) with TAVR vs surgery. More patients had moderate/severe paravalvular leak with TAVR than surgery (11 [3.0%] vs 2 [0.7%] ; risk difference, 2.37% [95% CI, 0.17%- 4.85%]; P  = .05). New pacemaker implantation rates were higher for TAVR than surgery at 5 years (289 [39.1%] vs 94 [15.1%] ; hazard ratio, 3.30 [95% CI, 2.61-4.17]; log-rank P   & amp;lt; .001), as were valve reintervention rates (27 [3.5%] vs 11 [1.9%] ; hazard ratio, 2.21 [95% CI, 1.10-4.45]; log-rank P  = .02), although between 2 and 5 years only 6 patients who underwent TAVR and 7 who underwent surgery required a reintervention. Conclusions and Relevance Among intermediate-risk patients with symptomatic severe aortic stenosis, major clinical outcomes at 5 years were similar for TAVR and surgery. TAVR was associated with superior hemodynamic valve performance but also with more paravalvular leak and valve reinterventions.
    Type of Medium: Online Resource
    ISSN: 2380-6583
    URL: Article
    DOI: 10.1001/jamacardio.2022.2695
    Language: English
    Publisher: American Medical Association (AMA)
    Publication Date: 2022
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  • 10
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    Efficacy and Safety of Ensovibep for Adults Hospitalized With COVID-19 : A Randomized Controlled Trial
    American College of Physicians ; 2022
    In:  Annals of Internal Medicine Vol. 175, No. 9 ( 2022-09), p. 1266-1274
    Details
    In: Annals of Internal Medicine, American College of Physicians, Vol. 175, No. 9 ( 2022-09), p. 1266-1274
    Type of Medium: Online Resource
    ISSN: 0003-4819 , 1539-3704
    URL: Article
    DOI: 10.7326/M22-1503
    RVK:
    XA 23600
    Language: English
    Publisher: American College of Physicians
    Publication Date: 2022
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