TY - JOUR
TI - Prognostic performance of critical care scores in patients undergoing transcatheter aortic valve implantation
AU - Georgiadou, P.
AU - Analitis, A.
AU - Sbarouni, E.
AU - Voudris, V.
JO - Journal of the Intensive Care Society
PY - 2016
VL - 17
TODO - 3
SP - 207-214
PB - SAGE Publications Inc.
SN - 1751-1437
TODO - 10.1177/1751143716638372
TODO - acetylsalicylic acid;  antibiotic agent;  clopidogrel, aged;  antibiotic therapy;  aorta valve stenosis;  APACHE;  area under the curve;  Article;  artificial heart pacemaker;  bleeding;  blood transfusion;  cerebrovascular accident;  comparative study;  death;  false aneurysm;  female;  femoral artery;  follow up;  heart tamponade;  human;  intensive care;  intensive care unit;  length of stay;  major clinical study;  male;  morbidity;  mortality;  MultiOrgan Dysfunction score;  multiple organ failure;  New York Heart Association class;  percutaneous aortic valve;  prognostic assessment;  receiver operating characteristic;  Sequential Organ Failure Assessment Score;  Simplified Acute Physiology Score;  transcatheter aortic valve implantation;  treatment outcome;  vascular access;  vascular closure device;  very elderly
TODO - Background: Critical care management of patients undergoing transcatheter aortic valve implantation (TAVI) is a major determinant of their outcome. Aims: The aim of this study was to compare the prognostic performance of four general scoring systems [Acute Physiology and Chronic Health Evaluation (APACHE), Simplified Acute Physiology Score (SAPS), Sequential Organ Failure Assessment (SOFA), and MultiOrgan Dysfunction (MOD) scores] in TAVI patients. Methods: Between 1 June 2008 and 30 June 2014, 75 patients (81.2 ± 6.4 years old, 36 men and 39 women) who underwent TAVI were scored during the first 24 h of their stay at the intensive care unit (ICU). The outcome measures were in-hospital and 30-day mortality and in-hospital and 30-day morbidity defined as myocardial infarction, implantation of permanent pacemaker, stroke, tamponade, major bleeding, vascular access site complications and prolonged ventilation. Results: Four patients (5.3%) died in ICU and one more during follow-up, indicating a 30-day mortality rate of 6.6%. Regarding in-hospital mortality, the area under the ROC curve (AUC) was 0.92 for SAPS II, 0.88 for APACHE II, 0.73 for MODS and 0.74 for SOFA. Regarding 30 day-mortality, SAPS II and APACHE II performed equally higher (AUC = 0.88) than the other two scores (0.79 for MODS and 0.80 for SOFA). SAPS II had the best calibration among all four scores for in-hospital and 30-day mortality (χ2= 3.06 and χ2= 3.29, respectively). AUCs for in-hospital and 30-day morbidity were above 0.7 for SAPS II and APACHE II. Conclusions: SAPS II and APACHE II are reliable mortality and morbidity risk stratification models for TAVI patients with high calibration and discrimination. © 2016, © The Intensive Care Society 2016.
ER -