Abstract: FR-PO084
Validation of a Six-Point Bedside Risk Score for Prediction of AKI After Transcatheter Aortic Valve Replacement
Session Information
- AKI: Epidemiology, Risk Factors, Prevention - I
November 03, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Acute Kidney Injury
- 101 AKI: Epidemiology, Risk Factors, and Prevention
Authors
- Gargar, Jenn Danielle Mahinay, St. Luke's Medical Center Global City, Metro Manila, Philippines
- Lim, Annabelle Sy, St. Luke's Medical Center Global City, Metro Manila, Philippines
- Marcellana, Gwen R., St. Luke's Medical Center Global City, Metro Manila, Philippines
- Posas, Fabio Enrique Bardales, St. Luke's Medical Center Global City, Metro Manila, Philippines
- Cruz, Kahlil Carlo A., St. Luke's Medical Center Global City, Metro Manila, Philippines
Background
Post-transcatheter aortic valve replacement (TAVR) acute kidney injury (AKI) is a significant complication linked to increased mortality, dialysis rates and myocardial infarction underscoring the need for a reliable prediction tool. Zivkovic et al. (2018) developed a bedside risk score with six pre-procedural variables (NYHA class, non-femoral access, valve-in-valve procedure, hemoglobin level, creatinine clearance, weight) to predict post-TAVR AKI. Validation of this score improve evidence for wider adoption in patient care.
Methods
A retrospective analysis of 205 patients who had TAVR was done. Patient characteristics were compared between AKI and non-AKI groups. Diagnostic accuracy was assessed using the receiver operating characteristics curve.
Results
AKI incidence was 18%. Significant AKI predictors were NYHA class (OR: 2.1170; p=0.001), non-femoral access site (OR: 2.6672; p=0.021), elevated baseline creatinine (OR: 4.1459; p<0.001), decreased hemoglobin levels (OR: 0.6319; p<0.001), eGFR<30 (OR: 0.9634; p<0.001). Age, gender and contrast volume showed no differences. AKI group had higher 10-year follow-up mortality (54.05% vs 31.55%, p=0.010), with 40% of AKI group mortalities occurring in the first year post-TAVR compared to 20% in non-AKI. Post-TAVR dialysis was higher in the AKI group (immediately after: 18.9%, 1 year post-TAVR: 16.2% vs. 0.0% respectively, p<0.001). The bedside risk score demonstrated promising discrimination (AUROC 0.75, accuracy of 69.76%), with a 23.43% increased odds of AKI per score increase.
Conclusion
Zivkovic et al.'s risk score shows promise in predicting post-TAVR AKI and can improve patient care through targeted monitoring and intervention. Guideline development for timely nephrology referral based on the risk score will optimize outcomes for high-risk patients.
Area under the ROC curve of Bedside Risk Score