Relationship Between Risk Scores and Acute Kidney Injury in Patients Undergoing Transcatheter Aortic Valve Replacement

Abstract

Introduction: Acute kidney injury (AKI) is a major predictor of mortality in patients undergoing transcatheter aortic valve replacement (TAVR). This study aimed to evaluate the relationship between the EuroSCORE II and STS scores, and the occurrence of AKI in patients undergoing TAVR.

Methods: A retrospective review was conducted on 105 patients who underwent TAVR for severe aortic stenosis at our clinic. Data on demographics, laboratory results, echocardiography, and procedural details were collected. AKI was defined according to the Valve Academic Research Consortium-2 (VARC-2) criteria.

Results:  Among the 105 patients, 65 (61.9%) were female, with a mean age of 77 ± 4.88 years. AKI developed in 31.4% of the patients. The mean STS score for the entire cohort was 8.03 ± 2.30, while the mean EuroSCORE II was 10.93 ± 7.53. In patients who developed AKI, the mean STS score was 14.35 ± 7.66 and the mean EuroSCORE II was 22.34 ± 6.07, while in patients without AKI, these scores were 5.26 ± 2.41 and 4.88 ± 3.07, respectively. The predictive value of EuroSCORE II and STS was assessed using the area under the ROC curve. A EuroSCORE II cut-off of 6.16 demonstrated 91% sensitivity and 68% specificity, while an STS score cut-off of 6.30 showed 84% sensitivity and 75% specificity for predicting AKI following TAVR.

Conclusion:  Both the STS score and EuroSCORE II, originally developed to predict postoperative mortality, may also serve as predictors of AKI in patients undergoing TAVR.