Predictive effect of nutritional scores assessment for 1-year mortality in patients with severe aortic stenosis treated with SAVR or TAVR.

Abstract

As treatment modalities of severe AS, interventional treatments such as SAVR or TAVR with the decision of the heart team have been performed recently. Controlling nutritional status (CONUT) score and prognostic nutritional index (PNI) have a very important place among the scores that provide a simple, effective, and objective evaluation of prognosis. In our study, we aimed to investigate the short-term prognostic results of severe AS patients who underwent TAVR or SAVR by comparing the CONUT and PNI results of the patients. 258 patients who underwent percutaneous TAVR or SAVR in our clinic between December 2012 and December 2020 were included in the study in a randomized retrospective manner. The primary endpoint of the study was in-hospital and 1-year all-cause death. The results of all patient groups were compared by dividing them into 2 groups as all-cause death group (deceased group) and non-all-cause death group (survived group) within 1 year. All-cause mortality occurred in 57 (29%) patients within 1 year. As nutritional status scores, the PNI score (39.9±7.4 vs. 46.5±6.9, p<0.001) was lower in the deceased group and the median CONUT score [4(4) vs. 1(3) p<0.001] was found significantly higher. NLR score was also found to be significantly higher in the deceased group (p<0.001). They were divided into 3 tertiles containing an equal number of patients and compared according to the nutritional scores. Significantly higher 1-year mortality was observed in the high CONUT [10 (12%) deaths in T1, 12 (14%) in T2, and 35 (41%) deaths in T3, respectively, p<0.001] and low PNI [37 (43%) deaths in T1, 13 (15%) in T2, and 7 (8%) deaths in T3, respectively, p<0.001] groups, which can be considered as the worse nutritional group. In the surgical or transarterial treatment of symptomatic severe aortic stenosis, we found that a high CONUT score and a low PNI score were predictors of all-cause mortality at 1-year follow-up, regardless of the type of treatment. We think that checking patients with scores like the abovementioned procedure and making the necessary corrections will lead to positive results in terms of prognosis.