• Fausto Biancari, Tatu Juvonen, Francesco Onorati, Giuseppe Faggian, Jouni Heikkinen, Juhani Airaksinen, and Giovanni Mariscalco.
• Department of Surgery, Oulu University Hospital, Oulu, Finland. Electronic address: faustobiancari@yahoo.it.
• J. Cardiothorac. Vasc. Anesth. 2014 Dec 1; 28 (6): 1533-9.

ObjectiveTo evaluate the performance of the EuroSCORE II (ESII) and the Society of Thoracic Surgeons (STS) scores in surgical (SAVR) or transcatheter aortic valve replacement (TAVR).DesignSystematic review of the literature and meta-analysis.SettingUniversity hospitals.ParticipantsStudies reporting data on the performance of ESII and STS scores in patients undergoing SAVR or TAVR.InterventionsSAVR or TAVR.Measurements And Main ResultsTen studies validated these scores in 13,856 patients who underwent either TAVR or SAVR. Operative mortality was 5.9% (SAVR 3.1%; TAVR 9.6%). ESII-expected mortality was 5.1% (O/E ratio: 1.15, SAVR, O/E ratio 0.94; TAVR, O/E ratio 1.23) and STS-expected mortality was 6.3% (O/E ratio: 0.94, SAVR, O/E ratio 0.84; TAVR, O/E ratio 1.13). The area under the ROC curve for ESII was 0.70 and for STS was 0.70 (SAVR patients: 0.73 for ESII and 0.75 for STS; TAVR patients; 0.66 for ESII and 0.63 for STS). The difference between observed/expected mortality was not significant for ESII (Peto's OR 0.99, p = 0.88) and was significant for STS (Peto's OR 0.86, p = 0.008). ESII (Peto's OR 1.35, p<0.00001) and STS (Peto's OR 1.23, p<0.00001) significantly underestimated the mortality risk in TAVR patients. The STS (Peto's OR 0.74, p<0.0001) and, to a lesser extent, the ESII (Peto's OR 0.86, p = 0.0.04) overestimated the mortality risk in SAVR patients.ConclusionsThe ESII and STS scores have good O/E ratios for either TAVR or SAVR patients, but both scores significantly underpredicted the risk of TAVR patients. ESII seemed to be accurate in predicting the risk of SAVR patients.Copyright © 2014 Elsevier Inc. All rights reserved.

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