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Prediction of 30-day Mortality after Transcatheter Aortic Valve Implantation: A Comparison of Logistic EuroSCORE, STS score, and EuroSCORE II

Johansson, Malin LU ; Nozohoor, Shahab LU ; Zindovic, Igor LU ; Nilsson, Johan LU ; Kimblad, Per Ola LU and Sjögren, Johan LU (2014) In Journal of Heart Valve Disease 23(5). p.567-574
Abstract
Background and aim of the study: The logistic EuroSCORE and STS score have been used for the selection of suitable TAVI patients, but their predictive ability is unsatisfactory. The study aim was to evaluate the performance of the EuroSCORE II in predicting 30-day mortality after TAVI in comparison to the logistic EuroSCORE and STS scoring systems. Methods: Between January 2008 and April 2013, a total of 123 consecutive patients underwent TAVI (transapical, n = 85; transfemoral, n = 38) at the authors' institution. Calibration and discriminatory ability was evaluated for three risk scores models (logistic EuroSCORE, STS score, and EuroSCORE II), and compared for the prediction of 30-day mortality using the Hosmer-Lemeshow test for... (More)
Background and aim of the study: The logistic EuroSCORE and STS score have been used for the selection of suitable TAVI patients, but their predictive ability is unsatisfactory. The study aim was to evaluate the performance of the EuroSCORE II in predicting 30-day mortality after TAVI in comparison to the logistic EuroSCORE and STS scoring systems. Methods: Between January 2008 and April 2013, a total of 123 consecutive patients underwent TAVI (transapical, n = 85; transfemoral, n = 38) at the authors' institution. Calibration and discriminatory ability was evaluated for three risk scores models (logistic EuroSCORE, STS score, and EuroSCORE II), and compared for the prediction of 30-day mortality using the Hosmer-Lemeshow test for goodness-of-fit and receiver operating characteristics curve analysis. Results: The overall 30-day mortality was 4.1% (5/123). Predicted mortality was 25.0 +/- 15.7% by logistic EuroSCORE, 7.3 +/- 6.9% by STS score, and 7.8 +/- 8.7% by EuroSCORE II. The observed/expected mortality ratio was 0.16 for logistic EuroSCORE, 0.56 for STS score, and 0.52 for EuroSCORE II. The area under the curve was 0.69 (95% CI 0.54-0.84) for the logistic EuroSCORE, 0.60 (95% CI 0.38-0.82) for the STS score, and 0.66 (95% CI 0.46-0.86) for the EuroSCORE II. Conclusion: In the present study, the EuroSCORE II was found to predict 30-day mortality more accurately for the TAVI cohort than did the more established logistic EuroSCORE, and also to compare (at present) on a par with the STS score. However, there were no differences in discriminatory power between the models. It is believed that, in the absence of a more TAVI-oriented risk stratification system, the EuroSCORE II may be a valuable adjunct in the clinical setting. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Journal of Heart Valve Disease
volume
23
issue
5
pages
567 - 574
publisher
ICR Publishers
external identifiers
  • wos:000349573100007
  • scopus:84927797491
ISSN
0966-8519
language
English
LU publication?
yes
id
de0025af-0b79-4192-860d-e5c4523ff046 (old id 5185934)
date added to LUP
2015-04-01 07:35:33
date last changed
2017-11-05 04:11:58
@article{de0025af-0b79-4192-860d-e5c4523ff046,
  abstract     = {Background and aim of the study: The logistic EuroSCORE and STS score have been used for the selection of suitable TAVI patients, but their predictive ability is unsatisfactory. The study aim was to evaluate the performance of the EuroSCORE II in predicting 30-day mortality after TAVI in comparison to the logistic EuroSCORE and STS scoring systems. Methods: Between January 2008 and April 2013, a total of 123 consecutive patients underwent TAVI (transapical, n = 85; transfemoral, n = 38) at the authors' institution. Calibration and discriminatory ability was evaluated for three risk scores models (logistic EuroSCORE, STS score, and EuroSCORE II), and compared for the prediction of 30-day mortality using the Hosmer-Lemeshow test for goodness-of-fit and receiver operating characteristics curve analysis. Results: The overall 30-day mortality was 4.1% (5/123). Predicted mortality was 25.0 +/- 15.7% by logistic EuroSCORE, 7.3 +/- 6.9% by STS score, and 7.8 +/- 8.7% by EuroSCORE II. The observed/expected mortality ratio was 0.16 for logistic EuroSCORE, 0.56 for STS score, and 0.52 for EuroSCORE II. The area under the curve was 0.69 (95% CI 0.54-0.84) for the logistic EuroSCORE, 0.60 (95% CI 0.38-0.82) for the STS score, and 0.66 (95% CI 0.46-0.86) for the EuroSCORE II. Conclusion: In the present study, the EuroSCORE II was found to predict 30-day mortality more accurately for the TAVI cohort than did the more established logistic EuroSCORE, and also to compare (at present) on a par with the STS score. However, there were no differences in discriminatory power between the models. It is believed that, in the absence of a more TAVI-oriented risk stratification system, the EuroSCORE II may be a valuable adjunct in the clinical setting.},
  author       = {Johansson, Malin and Nozohoor, Shahab and Zindovic, Igor and Nilsson, Johan and Kimblad, Per Ola and Sjögren, Johan},
  issn         = {0966-8519},
  language     = {eng},
  number       = {5},
  pages        = {567--574},
  publisher    = {ICR Publishers},
  series       = {Journal of Heart Valve Disease},
  title        = {Prediction of 30-day Mortality after Transcatheter Aortic Valve Implantation: A Comparison of Logistic EuroSCORE, STS score, and EuroSCORE II},
  volume       = {23},
  year         = {2014},
}