Key result
The ACC/TVT registry risk model demonstrated good discrimination for predicting in-hospital mortality after TAVI (C-index 0.74), performing similarly to the STS-PROM and EuroSCORE II models.
Why the study?
Does the ACC/TVT registry risk model accurately predict in-hospital and 30-day mortality compared to STS-PROM and EuroSCORE II in patients undergoing TAVI?
Cohort (n=1,038)
No
Does the ACC/TVT registry risk model accurately predict in-hospital and 30-day mortality compared to STS-PROM and EuroSCORE II in patients undergoing TAVI?
Effect estimate: C-index 0.74 (95% CI 0.59-0.88)
Absolute Event Rate: 0.74% vs 0.784%
p-value: p=0.81
The ACC/TVT registry risk model is a valid, dedicated tool for predicting in-hospital mortality after TAVI, performing comparably to established surgical risk scores like STS-PROM and EuroSCORE II.
Supports ACC/TVT model for TAVI mortality prediction; leaves open prospective validation before clinical adoption.
AIMS: The risk assessment tools currently used to predict mortality in transcatheter aortic valve implantation (TAVI) were designed for patients undergoing cardiac surgery. We aimed to assess the accuracy of the TAVI dedicated risk score in predicting mortality outcomes. METHODS AND RESULTS: Consecutive patients (n=1,038) undergoing TAVI at a single institution from 2014 to 2016 were included. The ACC/TVT registry mortality risk score, the STS-PROM score and the EuroSCORE II were calculated for all patients. In-hospital and 30-day all-cause mortality rates were 1.3% and 2.9%, respectively. The ACC/TVT risk stratification tool scored higher for patients who died in-hospital than for those who survived the index hospitalisation (6.4±4.6 vs. 3.5±1.6, p=0.03, respectively). The ACC/TVT score showed a high level of discrimination, C-index for in-hospital mortality 0.74, 95% CI: (0.59-0.88). There were no significant differences between the performance of the ACC/TVT registry risk score, the EuroSCORE II and the STS-PROM score for in-hospital and 30-day mortality rates. CONCLUSIONS: The ACC/TVT registry risk model is a dedicated tool to aid in the prediction of in-hospital mortality risk after TAVI.
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Codner et al. (2018) conducted a cohort in Severe aortic stenosis (n=1,038). ACC/TVT registry risk score vs. STS-PROM score and EuroSCORE II was evaluated on In-hospital all-cause mortality discrimination (C-index) (C-index 0.74, 95% CI 0.59-0.88, p=0.81). The ACC/TVT registry risk model demonstrated good discrimination for predicting in-hospital mortality after TAVI (C-index 0.74), performing similarly to the STS-PROM and EuroSCORE II models.
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