Abstract
Introduction Despite encouraging short-term and midterm results, transcatheter aortic valve implantation (TAVI) interventions are still burdened from high rates of adverse events, stressing the need for accurate predictive risk instruments. We compared available surgical risk scores to describe unfavorable outcomes after TAVI. Methods The Age, Creatinine, and Ejection fraction (ACEF) score, the logistic Euroscore, and the Society of Thoracic Surgeons Mortality score (STS) were appraised for their independent power of prediction and for their accuracy (Cindex) to predict 30-day and medium-term mortality, according to the Valve Academic Research Consortium. Results Nine hundred and sixty-two patients were included. All the scores demonstrated a moderate positive correlation. The closest correlation was observed between the STS score and Euroscore. After logistic regression analysis, STS score and Logistic Euroscore provided independent prediction for short-term all-cause mortality [PU0.02, odds ratio (OR) 1.1; 95% confidence interval (CI) 1.06-1.31 and PU0.027, OR 1.03; 95% CI 1.01-1.405]. For in-hospital complications, only STS score performed significantly (PU0.005, OR 1.05; 95% CI 1.01-1.06). ACEF, Euroscore, and STS score showed low accuracy for 30-day all-cause mortality (area under the curve 0.6, 0.44-0.75; vs. 0.53, 0.42-0.61; vs. 0.62, 0.52-0.71, respectively), whereas STS score performed better for in-hospital complications (0.59, 0.55-0.64). Moreover, after Cox-multivariate adjustments, only ACEF score was near to significance to predict all-cause mortality at mid-term (OR 1.7; 0.8-2.9; PU0.058), showing the highest accuracy (0.63, 0.55-0.71). Conclusion In TAVI patients, ACEF score, STS score and Logistic Euroscore provided only a moderate correlation and a low accuracy both for 30-day and medium-term outcomes. Dedicated scores are needed to properly tailor time and kind of approach.
| Original language | English |
|---|---|
| Pages (from-to) | 894-898 |
| Number of pages | 5 |
| Journal | Journal of Cardiovascular Medicine |
| Volume | 14 |
| Issue number | 12 |
| DOIs | |
| Publication status | Published - Dec 2013 |
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Keywords
- Short-term and mid-term outcomes
- Surgical risk scores
- Transcatheter aortic valve implantation
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
Cite this
Inaccuracy of available surgical risk scores to predict outcomes after transcatheter aortic valve replacement. / D'Ascenzo, Fabrizio; Ballocca, Flavia; Moretti, Claudio; Barbanti, Marco; Gasparetto, Valeria; Mennuni, Marco; D'Amico, Maurizio; Conrotto, Federico; Salizzoni, Stefano; Omedè, Pierluigi; Colaci, Chiara; Zoccai, Giuseppe B.; Lupo, Mario; Tarantini, Giuseppe; Napodanno, Massimo; Presbitero, Patrizia; Sheiban, Imad; Tamburino, Corrado; Marra, Sebastiano; Gaita, Fiorenzo.
In: Journal of Cardiovascular Medicine, Vol. 14, No. 12, 12.2013, p. 894-898.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Inaccuracy of available surgical risk scores to predict outcomes after transcatheter aortic valve replacement
AU - D'Ascenzo, Fabrizio
AU - Ballocca, Flavia
AU - Moretti, Claudio
AU - Barbanti, Marco
AU - Gasparetto, Valeria
AU - Mennuni, Marco
AU - D'Amico, Maurizio
AU - Conrotto, Federico
AU - Salizzoni, Stefano
AU - Omedè, Pierluigi
AU - Colaci, Chiara
AU - Zoccai, Giuseppe B.
AU - Lupo, Mario
AU - Tarantini, Giuseppe
AU - Napodanno, Massimo
AU - Presbitero, Patrizia
AU - Sheiban, Imad
AU - Tamburino, Corrado
AU - Marra, Sebastiano
AU - Gaita, Fiorenzo
PY - 2013/12
Y1 - 2013/12
N2 - Introduction Despite encouraging short-term and midterm results, transcatheter aortic valve implantation (TAVI) interventions are still burdened from high rates of adverse events, stressing the need for accurate predictive risk instruments. We compared available surgical risk scores to describe unfavorable outcomes after TAVI. Methods The Age, Creatinine, and Ejection fraction (ACEF) score, the logistic Euroscore, and the Society of Thoracic Surgeons Mortality score (STS) were appraised for their independent power of prediction and for their accuracy (Cindex) to predict 30-day and medium-term mortality, according to the Valve Academic Research Consortium. Results Nine hundred and sixty-two patients were included. All the scores demonstrated a moderate positive correlation. The closest correlation was observed between the STS score and Euroscore. After logistic regression analysis, STS score and Logistic Euroscore provided independent prediction for short-term all-cause mortality [PU0.02, odds ratio (OR) 1.1; 95% confidence interval (CI) 1.06-1.31 and PU0.027, OR 1.03; 95% CI 1.01-1.405]. For in-hospital complications, only STS score performed significantly (PU0.005, OR 1.05; 95% CI 1.01-1.06). ACEF, Euroscore, and STS score showed low accuracy for 30-day all-cause mortality (area under the curve 0.6, 0.44-0.75; vs. 0.53, 0.42-0.61; vs. 0.62, 0.52-0.71, respectively), whereas STS score performed better for in-hospital complications (0.59, 0.55-0.64). Moreover, after Cox-multivariate adjustments, only ACEF score was near to significance to predict all-cause mortality at mid-term (OR 1.7; 0.8-2.9; PU0.058), showing the highest accuracy (0.63, 0.55-0.71). Conclusion In TAVI patients, ACEF score, STS score and Logistic Euroscore provided only a moderate correlation and a low accuracy both for 30-day and medium-term outcomes. Dedicated scores are needed to properly tailor time and kind of approach.
AB - Introduction Despite encouraging short-term and midterm results, transcatheter aortic valve implantation (TAVI) interventions are still burdened from high rates of adverse events, stressing the need for accurate predictive risk instruments. We compared available surgical risk scores to describe unfavorable outcomes after TAVI. Methods The Age, Creatinine, and Ejection fraction (ACEF) score, the logistic Euroscore, and the Society of Thoracic Surgeons Mortality score (STS) were appraised for their independent power of prediction and for their accuracy (Cindex) to predict 30-day and medium-term mortality, according to the Valve Academic Research Consortium. Results Nine hundred and sixty-two patients were included. All the scores demonstrated a moderate positive correlation. The closest correlation was observed between the STS score and Euroscore. After logistic regression analysis, STS score and Logistic Euroscore provided independent prediction for short-term all-cause mortality [PU0.02, odds ratio (OR) 1.1; 95% confidence interval (CI) 1.06-1.31 and PU0.027, OR 1.03; 95% CI 1.01-1.405]. For in-hospital complications, only STS score performed significantly (PU0.005, OR 1.05; 95% CI 1.01-1.06). ACEF, Euroscore, and STS score showed low accuracy for 30-day all-cause mortality (area under the curve 0.6, 0.44-0.75; vs. 0.53, 0.42-0.61; vs. 0.62, 0.52-0.71, respectively), whereas STS score performed better for in-hospital complications (0.59, 0.55-0.64). Moreover, after Cox-multivariate adjustments, only ACEF score was near to significance to predict all-cause mortality at mid-term (OR 1.7; 0.8-2.9; PU0.058), showing the highest accuracy (0.63, 0.55-0.71). Conclusion In TAVI patients, ACEF score, STS score and Logistic Euroscore provided only a moderate correlation and a low accuracy both for 30-day and medium-term outcomes. Dedicated scores are needed to properly tailor time and kind of approach.
KW - Short-term and mid-term outcomes
KW - Surgical risk scores
KW - Transcatheter aortic valve implantation
UR - http://www.scopus.com/inward/record.url?scp=84890115481&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84890115481&partnerID=8YFLogxK
U2 - 10.2459/JCM.0b013e3283638e26
DO - 10.2459/JCM.0b013e3283638e26
M3 - Article
C2 - 23877207
AN - SCOPUS:84890115481
VL - 14
SP - 894
EP - 898
JO - Journal of Cardiovascular Medicine
JF - Journal of Cardiovascular Medicine
SN - 1558-2027
IS - 12
ER -