Predicting 30-day mortality of aortic valve replacement by the AVR score |
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Authors: | B. M. Swinkels F. E. E. Vermeulen J. C. Kelder W. J. van Boven H. W. M. Plokker J. M. ten Berg |
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Affiliation: | 1Department of Cardiology, St. Antonius Hospital, P.O. Box 2500, 3435 CM Nieuwegein, the Netherlands ;2Department of Cardiothoracic Surgery, St. Antonius Hospital, Nieuwegein, the Netherlands |
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Abstract: | Objectives The objective of this study is to develop a simple risk score to predict 30-day mortality of aortic valve replacement (AVR). Methods In a development set of 673 consecutive patients who underwent AVR between 1990 and 1993, four independent predictors for 30-day mortality were identified: body mass index (BMI) ≥30, BMI <20, previous coronary artery bypass grafting (CABG) and recent myocardial infarction. Based on these predictors, a 30-day mortality risk score—the AVR score—was developed. The AVR score was validated on a validation set of 673 consecutive patients who underwent AVR almost two decennia later in the same hospital. Results Thirty-day mortality in the development set was ≤2% in the absence of any predictor (class I, low risk), 2–5% in the solitary presence of BMI ≥30 (class II, mild risk), 5–15% in the solitary presence of previous CABG or recent myocardial infarction (class III, moderate risk), and >15% in the solitary presence of BMI <20, or any combination of BMI ≥30, previous CABG or recent myocardial infarction (class IV, high risk). The AVR score correctly predicted 30-day mortality in the validation set: observed 30-day mortality in the validation set was 2.3% in 487 class I patients, 4.4% in 137 class II patients, 13.3% in 30 class III patients and 15.8% in 19 class IV patients. Conclusions The AVR score is a simple risk score validated to predict 30-day mortality of AVR. |
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Keywords: | Aortic valve stenosis Aortic valve replacement EuroSCORE STS score |
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