Abstract 14737: Comparison Between Different Risk Scoring Algorithms in Isolated Conventional or Transcatheter Aortic Valve Replacement
Objectives:Important scores for risk evaluation in cardiac surgery are the EuroSCORE, the STS-Score, the ACEF-Score and more recently, the new EuroSCORE-II has been launched. The aim of our study was to analyze and compare the predictive value of these scores in patients undergoing aortic valve replacement (AVR) or transcatheter aortic valve implantation (TAVI).
Methods: A total of 1512 consecutive patients undergoing either conventional AVR (n=1066) or TAVI (transfemoral: n=291, transapical: n=155) were enrolled.
Results: Logistic and additive EuroSCORE of all patients were13.9±13.0% and 8.0±3.4% on average. The mean STS-Score, the ACEF-Score and the EuroSCORE-II were 5.8±5.3%, 1.5%±0.6% and 4.4±4.7%. Overall mortality at 30-days was 5.7%. The area under the curve (AUC) was 73.3 for the logistic EuroSCORE and 73.3 for the additive EuroSCORE. The STS-Score showed an AUC of 69.1. AUC for both, the ACEF and EuroSCORE-II was 65.4 and 69.3. In the transfemoral TAVI-group, AUCs were 59.8 and 59.3 for the logistic and additive EuroSCORE, 63.1 for the STS-Score and 55.9 and 55.3 for the ACEF and EuroSCORE-II. In the transapical TAVI-group, AUCs were 83.5 and 79.2 for the logistic and additive EuroSCORE, 73.9 for the STS-Score and 61.6 and 77.4 for the ACEF and EuroSCORE-II.
Conclusion: In our total series of AVR and TAVI patients, 30-day mortality was predicted best by the STS-Score. Discrimination threshold predicting mortality was equal between all other risk-calculators, even the new EuroSCORE-II was surprisingly not superior in risk-prediction of AVR and TAVI patients.
- © 2012 by American Heart Association, Inc.