Clinical Factors and Outcomes When Real-World Heart Teams Overruled STS Risk Scores in TAVR Cases
Table 4
Outcomes by study groups.
TAVR
TAVR
SAVR
value (TAVR, STS PROM > 3% vs. ≤3%)
value (STS PROM ≤ 3%, TAVR vs. SAVR)
STS PROM ≤ 3% (N = 415)
STS PROM > 3% (N = 2,711)
STS PROM ≤ 3% (N = 1,438)
Postprocedural
Transfusion, N (%)
21 (5.1%)
292 (10.8%)
205 (14.3%)
<0.001
<0.001
Units of RBC transfused, mean ± SD
0.2 ± 1.0
0.3 ± 1.2
0.4 ± 1.4
0.029
<0.001
Postoperation length of stay (days), mean ± SD
2.5 ± 3.4
3.5 ± 4.7
5.9 ± 3.6
<0.001
<0.001
Postoperation length of stay (days), median (IQR)
2.0 (1.0–3.0)
2.0 (1.0–4.0)
5.0 (4.0–6.0)
<0.001
<0.001
Discharge to home, N (%)
385 (93.9%)
2235 (84.6%)
1248 (86.8%)
<0.001
<0.001
Death in hospital, N (%)
5 (1.2%)
70 (2.6%)
4 (0.3%)
0.088
0.031
Significant cardiac event, N (%)
5 (1.2%)
46 (1.7%)
0.461
Stroke, N (%)
5 (1.2%)
57 (2.1%)
11 (0.8%)
0.222
0.394
Acute kidney injury (stage 3), N (%)
3 (0.7%)
52 (2.1%)
13 (0.9%)
0.076
>0.999
Bleeding (disabling or life threatening), N (%)
6 (1.4%)
79 (2.9%)
0.086
Vascular access site complications, N (%)
17 (4.1%)
160 (5.9%)
0.138
Device complications, N (%)
4 (1.0%)
26 (1.0%)
>0.999
Aortic regurgitation (moderate to severe), N (%)
6 (1.5%)
52 (2.1%)
1 (0.7%)
0.463
0.684
Requirement for pacer or ICD, N (%)
26 (6.9%)
216 (9.5%)
58 (4.2%)
0.099
0.027
30-day follow-up
Mortality within 30-day, N (%)
8 (2.0%)
95 (3.6%)
9 (0.6%)
0.097
0.012
Readmission within 30 days, N (%)
36 (8.9%)
269 (10.3%)
107 (7.5%)
0.392
0.349
1-year follow-up
1year survival status, N (%)
Alive
342 (82.4%)
2138 (78.9%)
0.005
Died
34 (8.2%)
371 (13.7%)
Unknown
39 (9.4%)
202 (7.5%)
Survival at 1 year, % (95% CI)
91.6 (88.5–93.9)
86.0 (84.6–87.2)
0.002
Readmission free at 1 year, % (95% CI)^
71.5 (66.8–76.0)
71.1 (69.3–72.9)
0.721
Blank responses in the SAVR group represent data not collected in STS Adult Cardiac Surgery Database. Abbreviations: SD=standard deviation; STS PROM=predicted risk of mortality for surgical aortic valve replacement based on the Society for Thoracic Surgeon's risk model; ICD=implantable cardioverter defibrillator. Kaplan–Meier estimation; ^cumulative incidence function.
