TY  - BOOK
AU  - Pichard, Augusto D
TI  - The relative performance characteristics of the logistic European System for Cardiac Operative Risk Evaluation score and the Society of Thoracic Surgeons score in the Placement of Aortic Transcatheter Valves trial
SN  - 0022-5223
KW  - *Aortic Valve Stenosis/th [Therapy]
KW  - *Cardiac Catheterization
KW  - *Decision Support Techniques
KW  - *Heart Valve Prosthesis Implantation/mt [Methods]
KW  - *Outcome and Process Assessment (Health Care)
KW  - Aged
KW  - Aged, 80 and over
KW  - Aortic Valve Stenosis/di [Diagnosis]
KW  - Aortic Valve Stenosis/mo [Mortality]
KW  - Cardiac Catheterization/ae [Adverse Effects]
KW  - Cardiac Catheterization/mo [Mortality]
KW  - Chi-Square Distribution
KW  - Female
KW  - Heart Valve Prosthesis Implantation/ae [Adverse Effects]
KW  - Heart Valve Prosthesis Implantation/mo [Mortality]
KW  - Hospital Mortality
KW  - Humans
KW  - Logistic Models
KW  - Male
KW  - Patient Selection
KW  - Registries
KW  - Risk Assessment
KW  - Risk Factors
KW  - Societies, Medical
KW  - Time Factors
KW  - Treatment Outcome
KW  - MedStar Heart & Vascular Institute
KW  - Comparative Study
KW  - Journal Article
KW  - Randomized Controlled Trial
KW  - Research Support, N.I.H., Extramural
KW  - Research Support, Non-U.S. Gov't
N1  - Available online from MWHC library: 1994 - present, Available in print through MWHC library: 1999 - 2006
N2  - CONCLUSIONS: The STS and LES surgical risk scores overestimated 30-day/in-hospital mortality and were poor discriminators of post-TAVR mortality, but the calibration of the STS score was better in these high-risk patients. These data highlight the need for TAVR-specific risk models to optimize patient selection.Copyright � 2014 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved; METHODS: We compared predicted and observed 30-day/in-hospital and 1-year mortality of patients undergoing TAVR in the first Placement of Aortic Transcatheter Valves trial and continued access registry (N = 2466). The performance of the LES and STS scores (prospectively calculated) was evaluated using standard assessments of discrimination and calibration. Performance of STS and LES scores among 307 patients undergoing SAVR from the high-risk cohort of the randomized trial were also examined; OBJECTIVES: The logistic European System for Cardiac Operative Risk Evaluation (LES) score and the Society of Thoracic Surgeons (STS) score are validated to predict 30-day outcomes following surgical aortic valve replacement (SAVR) with or without coronary artery bypass grafting. Their performance when applied to patients undergoing transcatheter aortic valve replacement (TAVR) is controversial; RESULTS: In patients undergoing TAVR, the observed 30-day/in-hospital mortality was 6.5%, whereas the predicted 30-day mortality was higher by both STS score (11.4% +/- 3.9%) and LES score (26.6% +/- 16.2%). The discrimination for both scores was poor for 30-day/in-hospital and 1-year mortality. Calibration was better for STS score than for LES at 1 year but poor for both at 30 days among TAVR cohort. These results were consistent among the subgroups of patients undergoing transfemoral and transapical access; however, the STS score had better performance among the high-risk patients who underwent SAVR at 30 days but not 1 year
UR  - http://dx.doi.org/10.1016/j.jtcvs.2014.04.006
ER  -