Transkateter Aort Kapak Replasmanı Sonrası Mortaliteyi Öngörmede Glasgow Prognostik Skorunun Önemi

Öz Amaç Glasgow Prognostik Skoru (GPS) inflamatuar (C reaktif protein) ve nutrisyonel (albümin) parametrelerin birlikte kullanımı ile elde edilen bir skorlama sistemidir ve daha önce yapılan çalışmalarda çeşitli kardiyak patolojilerde prognostik değeri olduğu gösterilmiştir. Bu çalışmada, Transkateter aort kapak replasmanı (TAVR) yapılan hastalarda 1-yıllık mortaliteyi öngörmede Glasgow Prognostik Skoru (GPS)'nun kullanılabilirliğinin araştırılması amaçlanmıştır. Gereç ve Yöntem Hastanemizde, 2013-2017 yılları arasında ciddi, semptomatik aort darlığı tanısı ile TAVR uygulanan hastalar geriye dönük olarak çalışmaya dahil edilmiştir. Demografik, klinik ve laboratuvar verileri hasta dosyaları incelenerek elde edilmiştir. İşlem öncesi C-reaktif protein ve albumin değerleri kullanılarak GPS değeri hesaplanmıştır.Hastaların 1-yıllık mortalite verisine göre mortalite (+) ve mortalite (-) olmak üzere 2 grup oluşturulmuştur. Bulgular Bu çalışmaya toplam 170 hasta dahil edilmiş ve 59 hasta mortalite (+) grubu oluşturmuştur. Demografik verilerden kronik obstruktif akciğer hastalığı, serebrovasküler hastalık öyküsü olması, yüksek STS-TAVR, Euro SCORE II ve GPS mortalite grubunda daha yüksek saptanmıştır. İşlem öncesi verilerle hesaplanan GPS değerinin yüksek olması 1-yıllık mortalitenin öngördürücüsü olarak belirlenmiştir. Tartışma İnflamasyon ve nutrisyonel durumun birlikte değerlendirilmesine olanak sağlayan Glasgow Prognostik Skoru, rutin laboratuar tetkiklerinden elde edilebilen pratik bir yöntemdir. TAVR uygulanan hastalarda mortalite öngördürücüsü olarak kullanılabilir. İşlem öncesi mortaliteyi azaltabilmek yönünde koruyucu önlemlerin alınmasında klinisyenlere yol gösterebilir.

Anahtar Kelimeler:

Glasgow prognostik skoru, C-reaktif protein, albumin, transkateter aort kapak implantasyonu

The Utility of Glasgow Prognostic Score as an Indicator of Mortality After Transcatheter Aortic Valve Implantation

Aim The Glasgow Prognostic Score (GPS) is a scoring system obtained by using inflammatory (C-reactive protein) and nutritional (albumin) parameters together, and it has been shown to have prognostic value in various cardiac pathologies in previous studies. In this study, we aimed to investigate the usability of the Glasgow Prognostic Score (GPS) in predicting 1-year mortality in patients who underwent transcatheter aortic valve implantation (TAVI). Method Patients who underwent TAVI with the diagnosis of severe, symptomatic aortic stenosis in our hospital between 2013 and 2017 were included in this single center study retrospectively. Demographic, clinical and laboratory data were obtained by reviewing patient files. GPS value was calculated by using C-reactive protein and albumin values which was obtained on admission to. Two groups were formed as survivors and non-survivors according to 1-year mortality data. Results A total of 170 patients were included in this retrospective study and 59 patients constituted the non-survivors group. History of chronic obstructive pulmonary disease and cerebrovascular disease were higher in non-survivors’ group. High STS-TAVR, Euro SCORE II and GPS levels were also higher in non-survivors group. High GPS value calculated with pre-procedural data was determined as a predictor of 1-year mortality. Conclusion The Glasgow Prognostic Score allows the evaluation of inflammation and nutritional status together, is a practical method that can be obtained from routine laboratory parameters. It can be used as a predictor of mortality in patients undergoing TAVI. It can guide clinicians in taking preventive measures to reduce mortality before the procedure.

Keywords:

Glasgow Prognostic Score, C-reactive protein, albumin, transcatheter aortic valve implantation,

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