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Kateterburen aortaklaffsimplantation - Alfresco - Västra

4.8±3.8% p=0.0007 for EuroSCORE II). The STS showed an AUC of 0 EuroSCORE STS 15,63% 18,75% 50,87% 13,31% Rycina 1. Porównanie obserwowanej śmiertelności z ryzykiem śmiertelności szacowanym za pomocą modeli EuroSCORE i STS [12, 13] Rycina 2. Przewidywana i obserwowana śmiertelność wśród pacjentów wysokiego ryzyka przy użyciu modeli EuroSCORE i STS [13] To investigate the prognostic value of the EuroSCORE II and the STS score in terms of cumulative mortality, Stähli et al. analysed 350 patients undergoing TAVI during a mean follow-up of 410 days and were able to demonstrate a significantly higher EuroSCORE II in non-survivors compared with survivors, whereas the STS score was not significantly different between the 2 groups. STS and EuroSCORE (logistic [E-log] and additive [E-add]) mortality risk scores were calculated for each patient. In addition, EuroSCORE calculations were validated against a downloaded EuroSCORE calculator (www.EuroSCORE.org) for 100 randomly selected patients. The STS score and EuroSCORE II have fair accuracy in predicting 30-day mortality risk after SAVR.

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The Society of Thoracic Surgeons (STS) score. Risk-model för  kateterburen (TAVI) framför öppen (SAVR) intervention: b STS score/EuroSCORE II ≥4 procent eller logistisk EuroSCORE I ≥10 procent. An STS score ≥10; or Logistic EuroScore I ≥ 15; or a determination by one cardiovascular surgeon and one cardiologist that the co-morbidities not captured by  20% Euroscore eller > 10 STS-score. 2. Något ökad risk men som anses operabla.

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STS vs. Euroscore II 0.36.

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Avec la révision du STS score en 2008 et la modification récente de l’EuroSCORE II, il faudra attendre plusieurs mois avant de pouvoir déterminer les performances rekommenderas hos patienter med lägre risk (STS eller EuroSCORE II<4% eller EuroSCORE I<10%; riskvärdering skall ej endast baseras på score). Andra faktorer som skörhet, porslinsaorta, tidigare strålbehandling mot mediastinum osv bör också inkluderas i riskvärderingen). Beslut bör tas vid regelbundna specialistöverskridande ronder och O Euroscore pode ser também calculado mas com recomendação fraca (IIb). Por que isso? No documento é citado trabalho prévio que sugere que o STS de fato tem poder discriminatório melhor em relação à mortalidade intra-hospitalar, apesar de ser enfatizado que os estudos são heterogêneos sobre o tema. O EuroSCORE II é baseado num banco de dados de 22 000 doentes submetidos a cirurgia cardíaca em 154 hospitais de 43 países, entre maio e julho de 2010; o STS‐PROM, que só pode ser usado para a substituição valvular aórtica isolada, para a doença valvular mitral isolada (plastia e substituição), para a cirurgia de revascularização miocárdica isolada (CABG) e para a CABG com tischer EuroScore: 28,5±18,2%) mit hoch-gradiger, symptomatischer Aortenklap-penstenose.

A number of randomised trials have compared the outcome of TAVI versus sAVR in patients at high risk for sAVR (mean STS score 7-11%, mean logistic EuroSCORE 18-29%) [2,13]. Results up to five years have shown that TAVI is non-inferior to sAVR and those patients who are suitable candidates for transfemoral access have an additional benefit from TAVI. Johansson, Malin et al. "Prediction of 30-day Mortality after Transcatheter Aortic Valve Implantation: A Comparison of Logistic EuroSCORE, STS score, and EuroSCORE II". Journal of Heart Valve Disease. 2014, 23(5). 567-574. However, the predictive ability of currently used surgical risk scores, such as the logistic EuroSCORE and the STS PROM is disputable, since after implementation of clinical best practice recommendations for transcatheter aortic valve implantation (TAVI) and the introduction of next generation transcatheter heart valves (THVs) outcomes could be improved significantly.
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18.6±7.3% p=0,0001 for STS and 13.9±16.1 vs. 4.8±3.8% p=0.0007 for EuroSCORE II). The STS showed an AUC of 0 EuroSCORE STS 15,63% 18,75% 50,87% 13,31% Rycina 1. Porównanie obserwowanej śmiertelności z ryzykiem śmiertelności szacowanym za pomocą modeli EuroSCORE i STS [12, 13] Rycina 2. Przewidywana i obserwowana śmiertelność wśród pacjentów wysokiego ryzyka przy użyciu modeli EuroSCORE i STS [13] To investigate the prognostic value of the EuroSCORE II and the STS score in terms of cumulative mortality, Stähli et al.

CL: calibration-in-the-large. Patients who died had EuroSCORE II and STS higher than the survivors (33.7±16.7vs. 18.6±7.3% p=0,0001 for STS and 13.9±16.1 vs. 4.8±3.8% p=0.0007 for EuroSCORE II). The STS showed an AUC of 0.81 and the EuroSCORE II of 0.77 and there were no differences in the discrimination ability using ROC curves (p=0.72).
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Johansson, Malin et al. "Prediction of 30-day Mortality after Transcatheter Aortic Valve Implantation: A Comparison of Logistic EuroSCORE, STS score, and EuroSCORE II". Journal of Heart Valve Disease. 2014, 23(5). 567-574. However, the predictive ability of currently used surgical risk scores, such as the logistic EuroSCORE and the STS PROM is disputable, since after implementation of clinical best practice recommendations for transcatheter aortic valve implantation (TAVI) and the introduction of next generation transcatheter heart valves (THVs) outcomes could be improved significantly. Risikoscores „The Society Thoracic of Surgeons-Score“ (STS-Score) und „Logistischer EuroSCORE“ (ES log) werden in den Leitlinien zur Risikoeinschätzungen von Patienten mit hochgradiger Aortenklappenstenose empfohlen. Patienten mit hohem Risiko werden mit einer TAVI versorgt.

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Nearly 20 thousand consecutive patients from 128 hospitals in eight European countries were studied. The European System for Cardiac Operative Risk Evaluation (EuroSCORE) II was developed to reflect a more current dataset and evidence-based improvements in cardiac surgery. In the United States, The Society of Thoracic Surgeons (STS) risk score is more accepted owing to relatively high predictive value despite less user friendliness and inapplicability to some cardiac surgeries.

analysed 350 patients undergoing TAVI during a mean follow-up of 410 days and were able to demonstrate a significantly higher EuroSCORE II in non-survivors compared with survivors, whereas the STS score was not significantly different between the 2 groups. STS and EuroSCORE (logistic [E-log] and additive [E-add]) mortality risk scores were calculated for each patient. In addition, EuroSCORE calculations were validated against a downloaded EuroSCORE calculator (www.EuroSCORE.org) for 100 randomly selected patients. The STS score and EuroSCORE II have fair accuracy in predicting 30-day mortality risk after SAVR. 10,11 However, a meta-analysis of 24 studies including 12,346 TAVR patients concluded that discrimination of 30-day mortality based on the STS score, logistic EuroSCORE, and EuroSCORE II was weak to modest, as all risk models reached an AUC of 0.62. 15 Further, the logistic EuroSCORE substantially Guidelines recommended using STS/EuroSCORE II for risk stratification, other risk factors including frailty and individual patient characteristics are important considerations 1, 2; Frailty assessment using tools, such as the Essential Frailty Toolset (EFT), allow for a more objective estimate 1 For aortic valve procedures and CABG plus valve procedures, the order of discriminative ability was STS risk score, EuroSCORE II, and EuroSCORE I. Logistic regression analyses found that all three risk scores significantly predicted operative mortality, but the STS risk score (odds ratio 1.13, 95% confidence interval: 1.12 to 1.15, p < 0.001) and EuroSCORE II (odds ratio 1.12, 95% confidence However, a direct comparison among STS, EuroSCORE II (ESII) and SYNTAX Score II (SSII) have never been performed.