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EuroSCORE II and STS as mortality predictors in patients undergoing TAVI / EuroSCORE II e STS como preditores de mortalidade em pacientes submetidos ao TAVI
Rosa, Vitor Emer Egypto; Lopes, Antonio Sergio de Santis Andrade; Accorsi, Tarso Augusto Duenhas; Fernandes, João Ricardo Cordeiro; Spina, Guilherme Sobreira; Sampaio, Roney Orismar; Paixão, Milena Ribeiro; Pomerantzeff, Pablo Maria; Lemos Neto, Pedro Alves; Tarasoutchi, Flávio.
  • Rosa, Vitor Emer Egypto; Clinical Unit of Heart Valve Disease. BR
  • Lopes, Antonio Sergio de Santis Andrade; Clinical Unit of Heart Valve Disease. BR
  • Accorsi, Tarso Augusto Duenhas; Clinical Unit of Heart Valve Disease. BR
  • Fernandes, João Ricardo Cordeiro; Clinical Unit of Heart Valve Disease. BR
  • Spina, Guilherme Sobreira; Clinical Unit of Heart Valve Disease. BR
  • Sampaio, Roney Orismar; Clinical Unit of Heart Valve Disease. BR
  • Paixão, Milena Ribeiro; Clinical Unit of Heart Valve Disease. BR
  • Pomerantzeff, Pablo Maria; Clinical Unit of Heart Valve Disease. BR
  • Lemos Neto, Pedro Alves; Clinical Unit of Heart Valve Disease. BR
  • Tarasoutchi, Flávio; Clinical Unit of Heart Valve Disease. BR
Rev. Assoc. Med. Bras. (1992) ; 62(1): 32-37, Jan.-Feb. 2016. tab, graf
Article in English | LILACS | ID: lil-777440
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.
RESUMO
RESUMO

Introdução:

STS e EuroSCORE II são os escores mais utilizados para a estratificação de risco cirúrgico e indicação do implante de válvula aórtica transcateter (TAVI). Entretanto, seu papel como ferramenta para predição de mortalidade em pacientes submetidos ao TAVI ainda é incerto.

Objetivo:

avaliar o desempenho do EuroSCORE II e STS como preditores de mortalidade intra-hospitalar em 30 dias em pacientes submetidos ao TAVI.

Métodos:

59 pacientes com estenose aórtica importante submetidos ao TAVI entre 2010 e 2014. Variáveis foram analisadas por meio do teste t-Student e teste exato de Fisher, e o poder discriminativo foi avaliado pela curva ROC e área sob a curva, acompanhada de intervalo de confiança de 95%.

Resultados:

a idade média foi de 81±7,3 anos, 42,3% homens. Média do EuroSCORE II foi de 6,07±7,3%, e do STS, 20,7±10,3%. Procedimento transfemoral foi realizado em 88,13%, transapical, em 3,38% e transaórtico, em 8,47%. A mortalidade intra-hospitalar foi 10,1%, e em 30 dias, 13,5%. Os pacientes que evoluíram para óbito apresentavam STS e EuroSCORE II mais elevados que os sobreviventes (33,7±16,7% vs. 18,6±7,3%; p=0,0001 para STS e 13,9±16,1% vs. 4,8±3,8%; p=0,0007 para EuroSCORE II). O STS apresentou AUC de 0,81, e o EuroSCORE II, 0,77. Não houve diferença na capacidade de discriminação pelas curvas ROC (p=0,72).

Conclusão:

STS e EuroSCORE II foram preditores de mortalidade intra-hospitalar em 30 dias.
Subject(s)


Full text: Available Index: LILACS (Americas) Main subject: Risk Assessment / Transcatheter Aortic Valve Replacement Type of study: Diagnostic study / Etiology study / Observational study / Prognostic study / Risk factors Limits: Aged / Aged80 / Female / Humans / Male Country/Region as subject: South America / Brazil Language: English Journal: Rev. Assoc. Med. Bras. (1992) Year: 2016 Type: Article Affiliation country: Brazil Institution/Affiliation country: Clinical Unit of Heart Valve Disease/BR

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Full text: Available Index: LILACS (Americas) Main subject: Risk Assessment / Transcatheter Aortic Valve Replacement Type of study: Diagnostic study / Etiology study / Observational study / Prognostic study / Risk factors Limits: Aged / Aged80 / Female / Humans / Male Country/Region as subject: South America / Brazil Language: English Journal: Rev. Assoc. Med. Bras. (1992) Year: 2016 Type: Article Affiliation country: Brazil Institution/Affiliation country: Clinical Unit of Heart Valve Disease/BR