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EuroSCORE II and STS score as a predictor of acute kidney injury following transcatheter aortic valve replacement: Two birds with one stone?

Nijad Bakhshaliyev, Nusret Acikgoz.




Abstract

Acute kidney injury (AKI) is a significant predictor of mortality in patients who underwent transcatheter aortic valve replacement (TAVR). Early identification and management of AKI can mitigate further complications and improve survival. The incidence and predictors of acute kidney injury in patients with TAVR were evaluated in different studies. Our aim is to evaluate EuroSCORE II and STS score in terms of predicting AKI following TAVR. One hundred and five patients who underwent TAVR procedure due to severe aortic stenosis in our clinic were retrospectively screened. Demographic, laboratory, echocardiographic and procedural data were collected retrospectively. AKI was defined according to the valve academic research consortium-2 (VARC-2). Sixty-five (61.9%) patients out of 105 were females with a mean age of 77.00 ±4.88 years. AKI developed in 31.4% of all patients who underwent TAVR. The mean ±standard deviation (SD) STS score was 8.03±2.30 while mean ±SD EuroSCORE II was 10.93±7.53. Mean±SD STS score and EuroSCORE II were 14.35±7.66 and 22.34 ±6.07 in patients who developed AKI respectively and 5.26 ±2.41 and 4.88 ±3.07 respectively in those who did not develop AKI. Multivariate analysis revealed that STS (odds ratio: 1.30; 95% CI: 1.04 to 1.62; p=0.02) and EuroSCORE II (odds ratio: 1.26; 95% CI: 1.10 to 1.44; p=0.001) were independent predictors of AKI. A EuroSCORE cut-off value of 6.16 exhibited a 91% sensitivity and 68% specificity while STS score cut-off value of 6.30 showed 84% sensitivity and 75% specificity in predicting AKI following TAVR. STS score and EuroSCORE II which were developed for the prediction of postoperative mortality may be the predictors of AKI in patients following TAVR.

Key words: Acute kidney injury, aortic stenosis, contrast media, renal dialysis, transcatheter aortic valve replacement






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