New risk factors in determining long­term mortality in patients undergoing TAVI: can the conventional risk scores be used as a long­term mortality predictor?

BACKGROUND: Surgical risk in patients after transcatheter aortic valve implantation (TAVI) is determined by conventional scoring systems. However, these risk scores were developed to predict surgical mortality. Due to their insufficient predictive ability in patients after TAVI, novel risk scores are needed to predict long­term mortality in this population. AIMS: The study aimed to investigate the value of conventional risk scores in predicting long­term mortality. Additionally, the impact of laboratory parameters on long­term mortality was evaluated. METHODS: Our study included 121 patients who underwent transfemoral TAVI. RESULTS: The mean (SD) logistic European System for Cardiac Operative Risk Evaluation (EuroSCORE), EuroSCORE II, and the Society of Thoracic Surgeons (STS) risk score were 27.4 (9.7), 7.9 (4.6), and 4.6 (2.4), respectively. In­hospital mortality rate was 1.7%. None of the risk scoring systems predicted in­hospital mortality correctly. The STS score corresponded with the mortality rate of approximately 2 months, EuroSCORE II, with 6 months, and logistic EuroSCORE, with 30 months. Male gender (odds ratio [OR], 5.668; 95% CI, 1.055­30.446; P = 0.04) and low albumin levels before TAVI (OR, 0.109; 95% CI, 0.018­0.654; P = 0.02) were found to be the independent predictors of long­term mortality. CONCLUSIONS: Although all conventional risk scores overestimated in­hospital mortality, the STS risk score predicted 2­month, EuroSCORE II, 6­month, and logistic EuroSCORE, 30­month mortality. The independent predictors of long­term mortality were male gender and low blood albumin levels before the TAVI procedure.