Περίληψη:
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.
Συγγραφείς:
Georgiadou, P.
Analitis, A.
Sbarouni, E.
Voudris, V.
Λέξεις-κλειδιά:
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
