EuroSCORE II and STS as mortality predictors in patients undergoing TAVI

Abstract

SUMMARY Introduction: the EuroSCORE II and STS are the most used scores for surgical risk stratification and indication of transcatheter aortic valve implantation (TAVI). However, its role as a tool for mortality prediction in patients undergoing TAVI is still unclear. Objective: to evaluate the performance of the EuroSCORE II and STS as predictors of in-hospital and 30-day mortality in patients undergoing TAVI. Methods: we included 59 symptomatic patients with severe aortic stenosis that underwent TAVI between 2010 and 2014. The variables were analyzed using Student's t-test and Fisher's exact test and the discriminative power was evaluated using receiver operating characteristic curve (ROC) and area under the curve (AUC) with a 95% confidence interval. Results: mean age was 81±7.3 years, 42.3% men. The mean EuroSCORE II was 7.6±7.3 % and STS was 20.7±10.3%. Transfemoral procedure was performed in 88.13%, transapical in 3.38% and transaortic in 8.47%. In-hospital mortality was 10.1% and 30-day mortality was 13.5%. Patients who died had EuroSCORE II and STS higher than the survivors (33.7±16.7vs. 18.6±7.3% p=0,0001 for STS and 13.9±16.1 vs. 4.8±3.8% p=0.0007 for EuroSCORE II). The STS showed an AUC of 0.81 and the EuroSCORE II of 0.77 and there were no differences in the discrimination ability using ROC curves (p=0.72). Conclusion: in this cohort, the STS and EuroSCORE II were predictors of in-hospital and 30-days mortality in patients with severe aortic stenosis undergoing TAVI.

Assessing the level of radiation experienced by anesthesiologists during transfemoral Transcatheter Aortic Valve Implantation and protection by a lead cap

“…A low-dose program and commonly applied measures for radiation protection as focusing on the area of interest and minimizing the distance between patient and flat-panel detector were used [14]. Demographic data of all patients were recorded and the operative risk was assessed by the EuroSCORE II [15].…”

Major adverse cardiac events and functional capacity in patients at intermediate risk undergoing transcatheter versus surgical aortic valve replacement for aortic stenosis with bicuspid valves

“…Nowadays, transcatheter aortic valve replacement (TAVR) plays an important role in the management of symptomatic severe aortic valve stenosis (AS) in patients who are considered not suitable for conventional surgery due to the high risk. Because of the risk of severe comorbidities and complications, the heart team needs to perform risk stratification using validated risk scores, such as the European System for Cardiac Operative Risk Evaluation (EuroSCORE) and the Society of Thoracic Surgeons (STS) score, 1 and make a decision before performing TAVR.…”

Post procedural risk assessment in patients undergoing trans aortic valve implantation according to the age, creatinine, and ejection fraction‐7 score: Advantages of age, creatinine, and ejection fraction‐7 in stratification of post‐procedural outcome

“…The most commonly used risk scores are derived from surgical collectives such as the EuroScore II and the STS score . Although they turned out to seem valuable tools in assessing patients’ surgical risks, they lack discriminative and predictive accuracy to identify patients who present a too high‐risk for TAVI with possible long‐term adverse events after the procedure . Therefore, many other risk scores including clinical, echocardiographic variables, and biomarkers have been evaluated in the recent past .…”

“…5,6 Although they turned out to seem valuable tools in assessing patients' surgical risks, they lack discriminative and predictive accuracy to identify patients who present a too high-risk for TAVI with possible longterm adverse events after the procedure. 7,8 Therefore, many other risk scores including clinical, echocardiographic variables, and biomarkers have been evaluated in the recent past. 9,10 The impact of renal function has also been addressed in patients undergoing surgical valve replacement, and in this group of patients both chronic kidney disease (CKD) and acute kidney injury (AKI) were found to be independent predictors of mortality.…”