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Article Dans Une Revue European Heart Journal Année : 2022

TRI-SCORE: a new risk score for in-hospital mortality prediction after isolated tricuspid valve surgery

Résumé

AIMS : Isolated tricuspid valve surgery (ITVS) is considered to be a high-risk procedure, but in-hospital mortality is markedly variable. This study sought to develop a dedicated risk score model to predict the outcome of patients after ITVS for severe tricuspid regurgitation (TR). METHODS AND RESULTS : All consecutive adult patients who underwent ITVS for severe non-congenital TR at 12 French centres between 2007 and 2017 were included. We identified 466 patients (60 ± 16 years, 49% female, functional TR in 49%). In-hospital mortality rate was 10%. We derived and internally validated a scoring system to predict in-hospital mortality using multivariable logistic regression and bootstrapping with 1000 re-samples. The final risk score ranged from 0 to 12 points and included eight parameters: age ≥70 years, New York Heart Association Class III-IV, right-sided heart failure signs, daily dose of furosemide ≥125 mg, glomerular filtration rate <30 mL/min, elevated bilirubin, left ventricular ejection fraction <60%, and moderate/severe right ventricular dysfunction. Tricuspid regurgitation mechanism was not an independent predictor of outcome. Observed and predicted in-hospital mortality rates increased from 0% to 60% and from 1% to 65%, respectively, as the score increased from 0 up to ≥9 points. Apparent and bias-corrected areas under the receiver operating characteristic curves were 0.81 and 0.75, respectively, much higher than the logistic EuroSCORE (0.67) or EuroSCORE II (0.63). CONCLUSION : We propose TRI-SCORE as a dedicated risk score model based on eight easy to ascertain parameters to inform patients and physicians regarding the risk of ITVS and guide the clinical decision-making process of patients with severe TR, especially as transcatheter therapies are emerging (www.tri-score.com).
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Origine : Publication financée par une institution

Dates et versions

hal-03379641 , version 1 (30-05-2022)

Identifiants

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Julien Dreyfus, Etienne Audureau, Yohann Bohbot, Augustin Coisne, Yoan Lavie-Badie, et al.. TRI-SCORE: a new risk score for in-hospital mortality prediction after isolated tricuspid valve surgery. European Heart Journal, 2022, 43 (7), pp.654-662. ⟨10.1093/eurheartj/ehab679⟩. ⟨hal-03379641⟩
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