
发表一篇学和医学成像类SCI论文
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Abstract:
BACKGROUND:Current guidelines recommend considering life expectancy before aortic valve replacement (AVR). We compared the performance of a general mortality index, the Lee index, to a frailty index. METHODS:We conducted a prospective cohort study of 246 older adults undergoing surgical (SAVR) or transcatheter aortic valve replacement (TAVR) at a single academic medical center. We compared performance of the Lee index to a deficit accumulation frailty index (FI). Logistic regression was used to assess the association of Lee index or FI with poor outcome, defined as death or functional decline with severe symptoms at 12 months. Discrimination was assessed using C-statistics. RESULTS:In the overall cohort, 44 experienced poor outcome (31 deaths, 13 functional decline with severe symptoms). The risk of poor outcome by Lee index quartiles was 6.8% (reference), 17.9% (odds ratio [OR], 3.0; 95% confidence interval, [0.9-10.2]), 20.0% (OR 3.4; [1.0-11.4]), and 34.0% (OR 7.1; [2.2-22.6]) (p-for-trend = 0.001). Risk of poor outcome by FI quartiles was 3.6% (reference), 10.3% (OR 3.1; [0.6-15.8]), 25.0% (OR 8.8; [1.9-41.0]), and 37.3% (OR 15.8; [3.5-71.1]) (p-for-trend< 0.001). The Lee index predicted the risk of poor outcome in the SAVR cohort Lee index (quartiles 1-4: 2.1, 4.0, 15.4, and 20.0%; p-for-trend = 0.04), but not in the TAVR cohort (quartiles 1-4: 27.3, 29.0, 21.3, 35.4%; p-for-trend = 0.42). In contrast, the FI did not predict the risk of poor outcome well in the SAVR cohort (quartiles 1-4: 2.3, 4.4, 15.8, and 0%; p-for-trend = 0.24), however in the TAVR cohort (quartiles 1-4: 9.1, 14.3, 29.7, and 40.7%; p-for-trend = 0.004). Compared to the Lee index, an FI demonstrated higher C-statistics in the overall (Lee index versus FI: 0.680 versus 0.735; p = 0.03) and TAVR (0.560 versus 0.644; p = 0.03) cohorts, but not SAVR cohort (0.724 versus 0.766; p = 0.09). CONCLUSIONS:While a general mortality index Lee index predicted death or functional decline with severe symptoms at 12 months well among SAVR patients, the FI derived from a multi-domain geriatric assessment better informs risk-stratification for high-risk TAVR patients.
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最新影响因子:4.07 | 期刊ISSN:1471-2318 | CiteScore:3.06 |
出版周期: | 是否OA:YES | 出版年份:0 |
自引率:7.60% | 研究方向:GERIATRICS & GERONTOLOGY- |
出版地区:ENGLAND |
SCI期刊coverage:Science Citation Index Expanded(科学引文索引扩展)
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BMC Geriatrics is an open access journal publishing original peer-reviewed research articles in all aspects of the health and healthcare of older people, including the effects of healthcare systems and policies. The journal also welcomes research focused on the aging process, including cellular, genetic, and physiological processes and cognitive modifications.
《BMC老年医学》是一本开放访问的期刊,发表了关于老年人健康和保健各个方面的原始同行评审研究文章,包括医疗保健系统和政策的影响。该杂志还欢迎关注衰老过程的研究,包括细胞、遗传和生理过程以及认知改变。
大类(学科) | 小类(学科) | 学科排名 |
医学 |
GERIATRICS & GERONTOLOGY (老年医学) 2区 GERONTOLOGY (老年医学) |
7/36 |
年度总发文量 | 年度论文发表量 | 年度综述发表量 |
290 | 266 | 24 |
引文计数(2018)
文献(2015-2017)
1636次引用
535篇文献
序号 | 类别 | 排名 | 百分位 |
1 |
大类(学科):Medicine
小类(学科):Geriatrics and Gerontology
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研究方向:老年医学
审稿时间: 3个月内 接受率: 中等(50%命中)
影响因子:5.576
ISSN:0885-3924
研究方向:医学-临床神经学
影响因子:6.005
ISSN:0192-415X
研究方向:医学-全科医学与补充医学
影响因子:202.731
ISSN:0140-6736
研究方向:医学-医学:内科
影响因子:2.898
ISSN:1807-5932
研究方向:医学-医学:内科
影响因子:1.817
ISSN:0025-7974
研究方向:医学-医学:内科
影响因子:3.006
ISSN:2044-6055
研究方向:MEDICINE, GENERAL & INTERNAL-
影响因子:0.834
ISSN:0020-9554
研究方向:医学-医学:内科
影响因子:0.522
ISSN:1108-4189
研究方向:MEDICINE, GENERAL & INTERNAL-
影响因子:11.15
ISSN:1741-7015
研究方向:医学-医学:内科
BMC Geriatrics 投稿经验
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