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Predicting 30-day mortality of aortic valve replacement by the AVR score

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Abstract

Objectives

The objective of this study is to develop a simple risk score to predict 30-day mortality of aortic valve replacement (AVR).

Methods

In a development set of 673 consecutive patients who underwent AVR between 1990 and 1993, four independent predictors for 30-day mortality were identified: body mass index (BMI) ≥30, BMI <20, previous coronary artery bypass grafting (CABG) and recent myocardial infarction. Based on these predictors, a 30-day mortality risk score—the AVR score—was developed. The AVR score was validated on a validation set of 673 consecutive patients who underwent AVR almost two decennia later in the same hospital.

Results

Thirty-day mortality in the development set was ≤2% in the absence of any predictor (class I, low risk), 2–5% in the solitary presence of BMI ≥30 (class II, mild risk), 5–15% in the solitary presence of previous CABG or recent myocardial infarction (class III, moderate risk), and >15% in the solitary presence of BMI <20, or any combination of BMI ≥30, previous CABG or recent myocardial infarction (class IV, high risk). The AVR score correctly predicted 30-day mortality in the validation set: observed 30-day mortality in the validation set was 2.3% in 487 class I patients, 4.4% in 137 class II patients, 13.3% in 30 class III patients and 15.8% in 19 class IV patients.

Conclusions

The AVR score is a simple risk score validated to predict 30-day mortality of AVR.

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Acknowledgements

We would like to thank Yvonne van Hees, MSc for her efforts in developing the databases and entering data. Furthermore, we are grateful to Diane Vermeulen, MD, MSc for her efforts in entering data, and to Geert J.M.G. van der Heijden, MD, MSc and Henry A. van Swieten, MD, PhD for their efforts in developing the databases.

Disclosures

This work was supported by Stichting Hartenzorg Sint Antonius, Nieuwegein; Stichting Nuts Ohra; and Jacques de Jong Stichting, all from the Netherlands.

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Authors and Affiliations

  1. Department of Cardiology, St. Antonius Hospital, P.O. Box 2500, 3435 CM, Nieuwegein, the Netherlands

    B. M. Swinkels, J. C. Kelder, H. W. M. Plokker & J. M. ten Berg

  2. Department of Cardiothoracic Surgery, St. Antonius Hospital, Nieuwegein, the Netherlands

    F. E. E. Vermeulen & W. J. van Boven

Authors
  1. B. M. Swinkels
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  2. F. E. E. Vermeulen
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  3. J. C. Kelder
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  4. W. J. van Boven
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  5. H. W. M. Plokker
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  6. J. M. ten Berg
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Corresponding author

Correspondence to B. M. Swinkels.

Additional information

Presented at the scientific spring meeting of the Dutch Society of Thoracic Surgery (NVT) on 21 May 2010 in Utrecht, the Netherlands.

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Swinkels, B.M., Vermeulen, F.E.E., Kelder, J.C. et al. Predicting 30-day mortality of aortic valve replacement by the AVR score. Neth Heart J 19, 273–278 (2011). https://doi.org/10.1007/s12471-011-0103-7

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  • DOI: https://doi.org/10.1007/s12471-011-0103-7

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