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
Clinical Unit of Heart Valve Disease, Brazil.
Surgical Unit of Heart Valve Disease, Brazil.
Rev Assoc Med Bras (1992). 2016 Jan-Feb;62(1):32-7. doi: 10.1590/1806-9282.62.01.32.
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.
to evaluate the performance of the EuroSCORE II and STS as predictors of in-hospital and 30-day mortality in patients undergoing TAVI.
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.
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).
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.
欧洲心脏手术风险评估系统II（EuroSCORE II）和胸外科医师协会（STS）评分是用于手术风险分层及经导管主动脉瓣植入术（TAVI）指征判断的最常用评分系统。然而，其作为TAVI患者死亡率预测工具的作用仍不明确。
评估EuroSCORE II和STS作为TAVI患者院内及30天死亡率预测指标的性能。
我们纳入了2010年至2014年间接受TAVI的59例有症状的重度主动脉瓣狭窄患者。使用学生t检验和Fisher精确检验分析变量，并通过受试者工作特征曲线（ROC）和曲线下面积（AUC）及其95%置信区间评估判别能力。
平均年龄为81±7.3岁，男性占42.3%。EuroSCORE II平均为7.6±7.3%，STS平均为20.7±10.3%。经股动脉手术占88.13%，经心尖手术占3.38%，经主动脉手术占8.47%。院内死亡率为10.1%，30天死亡率为13.5%。死亡患者的EuroSCORE II和STS高于存活患者（STS：33.7±16.7 vs. 18.6±7.3%，p = 0.0001；EuroSCORE II：13.9±16.1 vs. 4.8±3.8%，p = 0.0007）。STS的AUC为0.81，EuroSCORE II的AUC为0.77，使用ROC曲线评估判别能力无差异（p = 0.72）。
在该队列中，STS和EuroSCORE II是重度主动脉瓣狭窄接受TAVI患者院内及30天死亡率的预测指标。
