Evidence map›Paper›PMID 32153791›Full record

Observational studyOpen heart2020

Clinical value of the 20% logistic EuroSCORE cut-off for selecting TAVI candidates: a single-centre cohort study analysis.

Guram Imnadze, Steffen Hofmann, Michael Billion, Abbas Ferdosi, Marek Kowalski, Ehab Rajab, Karin Bramlage, Peter Bramlage, Henning Warnecke, Norbert Franz

Abstract readObservational Study
In one paragraph

Observational study in Open heart, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0cells of the map it votes in
0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

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5 · Who and what money

Authors and funding

10 authors.

Guram ImnadzeInstitut für Gesundheitsforschung und Bildung, Universität Osnabrück, Osnabrück, Germany.
Steffen HofmannDepartment of Cardiac Surgery, Schüchtermann Clinic, Bad Rothenfelde, Germany.
Michael BillionDepartment of Cardiac Surgery, Schüchtermann Clinic, Bad Rothenfelde, Germany.
Abbas FerdosiDepartment of Cardiac Surgery, Schüchtermann Clinic, Bad Rothenfelde, Germany.
Marek KowalskiDepartment of Cardiology, Schüchtermann Clinic, Bad Rothenfelde, Germany.
Ehab RajabDepartment of Cardiac Surgery, Schüchtermann Clinic, Bad Rothenfelde, Germany.
Karin BramlageInstitute for Pharmacology and Preventive Medicine, Cloppenburg, Germany.
Peter BramlageInstitute for Pharmacology and Preventive Medicine, Cloppenburg, Germany.ORCID 0000-0003-4970-2110
Henning WarneckeDepartment of Cardiac Surgery, Schüchtermann Clinic, Bad Rothenfelde, Germany.
Norbert FranzDepartment of Cardiology, Schüchtermann Clinic, Bad Rothenfelde, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: A logistic European System for Cardiac Operative Risk Evaluation (logEuroSCORE) ≥20% is frequently recognised as a finite criteria for transcatheter aortic valve implantation (TAVI) reimbursement, despite guideline modifications to reflect the appropriacy of TAVI in selected lower-risk patients. The aim was to evaluate the clinical value of this threshold cut-off in TAVI patients and to identify factors associated with mortality in those below this threshold. Methods: We analysed data from a single-centre, German, observational, TAVI-patient registry, gathered between 2008 and 2016. Patients were stratified by logEuroSCORE (≥ or <20%) for comparisons. Logistic regression was performed to identify predictors of mortality at 1 year, with this analysis used to generate a calculated ('real') risk value for each patient. Results: 1679 patients (logEuroSCORE <20%: n=789; logEuroSCORE ≥20%: n=890) were included. LogEuroSCORE <20% patients were significantly younger (80.1 vs 81.6 years; p<0.001) and less comorbid than logEuroSCORE ≥20% patients, with a higher rate of transfemoral TAVI (35.6% vs 26.1%; p<0.001) and predilation (70.0% vs 63.3%; p=0.004). Patients with a logEuroSCORE <20% experienced more vascular complications (3.4% vs 1.5%; p=0.010). One-year survival was 88.3% in the logEuroSCORE <20% and 81.8% in the logEuroSCORE ≥20% group (p=0.005), with the calculated mortality risk falling within 2% of the logEuroSCORE in just 12.9% of patients. In the logEuroSCORE <20% group, only coronary artery disease was significantly predictive of 1-year mortality (OR 2.408; 95% CI 1.361 to 4.262; p=0.003). Conclusions: At our institution, patients with a logEuroSCORE <20% selected for TAVI have excellent outcomes. The decision not to reimburse TAVI in such patients may be viewed as inappropriate.

Indexed as

Clinical Decision-MakingDecision Support TechniquesEligibility DeterminationPatient SelectionTranscatheter Aortic Valve ReplacementAgedAged, 80 and overAortic ValveAortic Valve StenosisFee-for-Service PlansFemaleGermanyHumansMalePredictive Value of TestsRegistriesaortic valve diseaseminimally invasivevalvular disease

Identifiers

PMID32153791
PMCPMC7046969

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.