The systemic inflammatory response syndrome predicts short-term outcome after transapical transcatheter aortic valve implantation

Abstract

Objective Despite the minimally invasive nature of transcatheter aortic valve implantation (TAVI), the incidence of acute kidney injury (AKI) and mortality is of major concern. Several studies showed that outcome was influenced by the systemic inflammatory response syndrome (SIRS) in patients undergoing percutaneous TAVI. The purpose of this study was to investigate whether SIRS after transapical TAVI was associated with short-term outcome. Design Retrospective analysis of prospectively collected data. Setting Intensive care unit in a tertiary-care hospital. Participants In 121 patients undergoing transapical TAVI for severe aortic stenosis between March 2010 and October 2013, the incidence of SIRS during the first 48 hours was studied. The relation between the occurrence of SIRS and any adverse event during hospital stay was investigated. Any adverse event was defined as the composite of mortality, AKI, infection, stroke, myocardial infarction, and bleeding. Intervention none. Measurements and Main Results Sixty-five (53.7%) patients developed SIRS during 48 hours after transapical TAVI. The occurrence of SIRS was associated independently with an increased risk of any adverse event (adjusted odds ratio: 4.0, 95% confidence interval [CI]: 1.6-9.6; p = 0.002), which was mainly an increased risk of death (odds ratio: 5.5, 95% CI: 1.1-25.9; p = 0.031). Patients with SIRS had a longer median duration of intensive care unit stay compared with patients without SIRS (2 v 1 day; p<0.001). Conclusions SIRS predicts short-term outcome in patients undergoing transapical TAVI.