Abstract 19032: Performance of Euroscore I, Euroscore II and STS Score for Risk Stratification of Patients Undergoing Transcatheter Aortic Valve Replacement
Purpose: Objective of this single center study was to assess and compare the performance of logistic Euroscore I (ES I), logistic Euroscore II (ES II) and the Society of Thoracic Surgeons (STS) mortality score for risk stratification of patients undergoing transcatheter aortic valve replacement (TAVR).
Methods: We analyzed data of 235 consecutive patients who underwent TAVR from June 2007 through January 2011. We calculated STS, ES1 and ES2 of each patient. Performance of the risk scores was evaluated by means of ROC curves. A logistic multivariable analysis was performed including confounding factors (age, sex) and access: percutaneous (trans-femoral and trans-subclavian) vs. surgical (trans-apical and trans-aortic) TAVI.
Results: Surgical and percutaneous TAVI were performed in 78 (33.2%) and 157 (66.8%) patients, respectively. Mean age was 80.5 ± 6.6 years. Median ES1, ES2 and STS scores were: 17.6%, 5.4% and 6.8% respectively. Thirty-day mortality was 4.3%, the incidence of combined safety events, according to VARC definitions, was 17%. The area under the ROC curve (AUC) for thirty-day mortality was 0.68, 0.66 and 0.60 for ES1, ES2 and STS, respectively (p=0.79). The AUC for combined safety events was 0.57, 0.60 and 0.57 for ES1, ES2 and STS, respectively (p=0.71). After correction for age, sex and approach the AUC for thirty-day mortality was 0.84, 0.75 and 0.74 for ES I, ES II and STS scores, respectively while the AUC for combined safety events was 0.68, 0.66 and 0.65 for ES I, ES II and STS scores, respectively. ES2 and STS performed better in predicting thirty-day mortality in surgical cases (0.75 and 0.74) while ES1 performed better in percutaneous cases (0.76).
Conclusion: According to our analysis, in patients undergoing TAVR, ES1, ES2 and STS scores for thirty-day mortality and for combined safety events provide similar but poor performance (less than 0.75). After correction for confounding factors and approach, ES1 was the only that showed AUC greater than 0.75.
- © 2012 by American Heart Association, Inc.