Why the study?
The authors aimed to determine whether separate consideration of BMI provides superior predictive value compared with established risk scores in isolated minimally invasive mitral valve surgery to inform decision-making.
Does body mass index provide superior predictive value for mortality and postoperative adverse events compared to EuroSCORE II and STS score in non-underweight patients undergoing minimally invasive mitral valve surgery?
Does body mass index provide superior predictive value for mortality and postoperative adverse events compared to EuroSCORE II and STS score in non-underweight patients undergoing minimally invasive mitral valve surgery?
Answers are grounded in this paper and cite their sources.
BMI is a superior predictor for wound healing disorders but inferior to established risk scores for predicting mortality in minimally invasive mitral valve surgery, suggesting it should not be the sole factor in treatment decision-making.
Background With this study we aimed to analyze if the separate consideration of body mass index (BMI) could provide any superior predictive values compared with the established risk scores in isolated minimally invasive mitral valve surgery (MIMVS). This might facilitate future therapeutic decision-making, e.g., regarding the question surgery versus transcatheter mitral valve repair (TMVr). Methods We assessed the relevance of BMI in non-underweight patients who underwent isolated MIMVS. The risk predictive potential of BMI for mortality and several postoperative adverse events was assessed in 429 consecutive patients. This predictive potential was compared with that of European System for Cardiac Outcome Risk Evaluation II (EuroSCORE II) and the Society of Thoracic Surgeons score (STS score) using a comparative receiver operating characteristic curve analysis. Results BMI was a significant numeric predictor of wound healing disorders (p = 0.001) and proved to be significantly superior in case of this postoperative adverse event compared with the EuroSCORE II (p = 0.040) and STS score (p = 0.015). Except for this, the predictive potential of BMI was significantly inferior compared with that of the EuroSCORE II and STS score for several end points, including 30-day (p = 0.029 and p = 0.006) and 1-year (p = 0.012 and p = 0.001) mortality. Conclusion Therefore, we suggest that, in the course of decision-making regarding the right treatment modality for non-underweight patients with isolated mitral valve regurgitation, the sole factor of BMI should not be given a predominant weight.
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Minol et al. (2021) studied this question.
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