A Novel Method to Predict Mortality and Length of Stay after Transfemoral Transcatheter Aortic Valve Implantation
Abstract
:1. Introduction
2. Materials and Methods
2.1. Inclusion Criteria
2.2. Exclusion Criteria
2.3. Collected Data
2.3.1. EuroSCORE II
2.3.2. Comorbidities
2.3.3. Laboratory Investigations/Biomarkers
2.3.4. EuroQol-5 Dimension-5 Levels (EQ5D5L)
2.3.5. Kansas City Cardiomyopathy Questionnaire (KCCQ)
2.3.6. Clinical Frailty Scale (CFS)
2.4. Intervention—TAVI Procedure
2.5. Clinical Endpoints
2.5.1. Primary Endpoint: Midterm Mortality
2.5.2. Secondary Endpoints
2.6. Statistical Analysis
3. Results
3.1. Predictors for the Primary Endpoint (Midterm Mortality after TAVI)
3.2. Predictors for the Secondary Endpoint LoS
3.3. Predictors for the Secondary Endpoint Complications
4. Discussion
4.1. Strengths of the Study
4.2. Study Limitations
4.3. Implications for Future Studies
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Baseline Characteristic | N | Range of Values | % of Total Participants |
---|---|---|---|
Male sex, N of participants | 86 | 50.89% of all participants | |
Age, years | 82.01 | (78.23–84.54) | – |
ES II, score values | 4 | (2.24–6.31) | – |
NYHA I, N of participants | 7 | 4.14% of all participants | |
NYHA II, N of participants | 43 | 25.44% of all participants | |
NYHA III, N of participants | 111 | 65.68% of all participants | |
NYHA IV, N of participants | 8 | 4.73% of all participants | |
HB, g/dL | 12.8 | (11.6–13.7) | – |
Creatinine, mg/dL | 1.04 | (0.86–1.29) | – |
e-GFR based on cystatin C, | 49.2 | (35.1–62.5) | – |
logNTProBNP | 1.701 | (0.564–3.896) | – |
PCI, N of participants | 90 | 53.25% of all participants | |
CAD, N of participants | 125 | 73.96% of all participants | |
PM, N of participants | 44 | 26.04% of all participants | |
AF, N of participants | 97 | 57.4% of all participants | |
COPD, N of participants | 53 | 31.36% of all participants | |
PAD, N of participants | 74 | 43.79% of all participants | |
DM, N of participants | 67 | 39.64% of all participants | |
Previous heart surgery, N | 28 | 16.57% of all participants | |
CPR, N of participants | 5 | 2.96% of all participants | |
Neurological dysfunction, N | 27 | 15.98% of all participants | |
LoS after TAVI, days | 6 | (5–8) | – |
CFS, score value | 4 | (3–5) | – |
EQ5D5L, score value | 62 | (45–83) | – |
KCCQ, score value | 43 | (33–52) | – |
Variable | HR (95% CI) Primary Endpoint Midterm Mortality | p-Value | HR (95% CI) Secondary Endpoint LoS > 6 days | p-Value | HR (95% CI) Secondary Endpoint Complications | p-Value |
---|---|---|---|---|---|---|
Male sex | 1.29 (0.41–4.07) | 0.662 | 0.77 (0.42–1.43) | 0.412 | 2.29 (1.09–4.85) | 0.030 |
Age | 1.11 (0.99–1.25) | 0.070 | 1.01 (0.97–1.05) | 0.792 | 1.02 (0.97–1.07) | 0.485 |
NYHA | 1.11 (0.43–2.87) | 0.830 | 1.06 (0.63–1.79) | 0.820 | 0.85 (0.47–1.54) | 0.585 |
HB | 1.00 (0.74–1.36) | 0.988 | 0.88 (0.74–1.04) | 0.133 | 1.22 (0.98–1.51) | 0.074 |
Creatinine | 1.47 (0.99–2.18) | 0.054 | 1.34 (0.88–2.03) | 0.176 | 1.11 (0.74–1.67) | 0.617 |
e-GFR | 0.96 (0.94–0.99) | 0.001 | 0.98 (0.96–0.99) | 0.000 | 0.99 (0.98–1.02) | 0.944 |
NTProBNP | 2.34 (1.42–3.86) | 0.001 | 2.12 (1.48–3.02) | 0.000 | 0.76 (0.41–1.41) | 0.387 |
CFS | 1.14 (0.83–1.56) | 0.405 | 1.25 (1.09–1.44) | 0.002 | 0.91 (0.73–1.15) | 0.444 |
EQ5D5L | 0.98 (0.96–1.01) | 0.134 | 0.98 (0.97–0.99) | 0.000 | 1.01 (0.99–1.02) | 0.346 |
KCCQ | 0.93 (0.89–0.98) | 0.005 | 0.98 (0.96–0.99) | 0.007 | 1.01 (0.98–1.03) | 0.691 |
ES II | 1.12 (1.06–1.18) | 0.000 | 1.04 (1.01–1.08) | 0.016 | 1.03 (0.99–1.06) | 0.064 |
AF | 2.25 (1.11–4.56) | 0.024 | 1.08 (0.67–1.74) | 0.757 | 0.64 (0.29–1.42) | 0.271 |
Infarct_bin | 1.46 (0.65–3.27) | 0.356 | - | - | - | - |
Cardio shock | 2.51 (1.21–5.16) | 0.013 | - | - | - | - |
CPR | 0.05 (0.00–121) | 0.557 | - | - | - | - |
COPD | 2.10 (1.02–4.33) | 0.044 | - | - | - | - |
PM | 0.98 (0.34–2.80) | 0.968 | - | - | - | - |
CAD | 1.22 (0.59–2.51) | 0.588 | - | - | - | - |
PCI | 1.19 (0.59–2.43) | 0.621 | - | - | - | |
DM | 0.77 (0.34–1.72) | 0.522 | - | - | - | |
PAD | 1.95 (0.96–3.94) | 0.064 | - | - | - | |
Neurol. Dysf. | 1.80 (0.74–4.39) | 0.196 | - | - | - | |
Ang. pectoris | 0.64 (0.38–1.05) | 0.079 | - | - | - |
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Zisiopoulou, M.; Berkowitsch, A.; Seppelt, P.; Zeiher, A.M.; Vasa-Nicotera, M. A Novel Method to Predict Mortality and Length of Stay after Transfemoral Transcatheter Aortic Valve Implantation. Medicina 2021, 57, 1332. https://doi.org/10.3390/medicina57121332
Zisiopoulou M, Berkowitsch A, Seppelt P, Zeiher AM, Vasa-Nicotera M. A Novel Method to Predict Mortality and Length of Stay after Transfemoral Transcatheter Aortic Valve Implantation. Medicina. 2021; 57(12):1332. https://doi.org/10.3390/medicina57121332
Chicago/Turabian StyleZisiopoulou, Maria, Alexander Berkowitsch, Philipp Seppelt, Andreas M. Zeiher, and Mariuca Vasa-Nicotera. 2021. "A Novel Method to Predict Mortality and Length of Stay after Transfemoral Transcatheter Aortic Valve Implantation" Medicina 57, no. 12: 1332. https://doi.org/10.3390/medicina57121332