Key result
Novel preoperative risk score linked to ~2.3-fold higher rate of prolonged hospital stay after TAVI.
Why the study?
The study sought to identify preoperative clinical data and patient-reported outcome measures capable of predicting length of stay in patients with significant aortic stenosis undergoing TAVI.
Cohort (n=302)
No
Answers are grounded in this paper and cite their sources.
A novel pre-operative risk score incorporating both clinical factors and patient-reported measures allows for personalized prediction of hospital length of stay after TAVI.
Background: The aim of this study was to identify pre-operative parameters able to predict length of stay (LoS) based on clinical data and patient-reported outcome measures (PROMs) from a scorecard database in patients with significant aortic stenosis who underwent TAVI (transfemoral aortic valve implantation). Methods: 302 participants (51.7% males, age range 78.2−84.2 years.) were prospectively recruited. After computing the median LoS value (=6 days, range = 5−8 days), we implemented a decision tree algorithm by setting dichotomized values at median LoS as the dependent variable and assessed baseline clinical variables and PROMs (Clinical Frailty Scale (CFS), EuroQol-5 Dimension-5 Levels (EQ-5D) and Kansas City Cardiomyopathy Questionnaire (KCCQ)) as potential predictors. Results: Among clinical parameters, only peripheral arterial disease (p = 0.029, HR = 1.826) and glomerular filtration rate (GFR, cut-off < 33 mL/min/1.73 m2, p = 0.003, HR = 2.252) were predictive of LoS. Additionally, two PROMs (CFS; cut-off = 3, p < 0.001, HR = 1.324 and KCCQ; cut-off = 30, p = 0.003, HR = 2.274) were strong predictors. Further, a risk score for LoS (RS_LoS) was calculated based on these predictors. Patients with RS_LoS = 0 had a median LoS of 5 days; patients RS_LoS ≥ 3 had a median LoS of 8 days. Conclusions: based on the pre-operative values of the above four predictors, a personalized prediction of LoS after TAVI can be achieved.
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Zisiopoulou et al. (2022) conducted a cohort in Severe symptomatic degenerative aortic valve stenosis (n=302). Preoperative predictors (PAD, GFR < 33, CFS, KCCQ) vs. Patients without these risk factors was evaluated on Length of stay > 6 days (HR 2.252, p=0.003). A preoperative risk score using PAD, reduced GFR, and patient-reported outcomes predicted length of stay after TAVI (median 8 days for score >=3 vs 5 days for score 0).
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