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Beyond EuroSCORE II - the Interplay Between EuroSCORE II and Aortic Calcification as Predictors of Clinical Outcomes in Postoperative Cardiac Surgery
Session:
Sessão de Posters 46 - TC Cardíaca
Speaker:
Adriana Rei Pacheco
Congress:
CPC 2024
Topic:
B. Imaging
Theme:
03. Imaging
Subtheme:
03.6 Cross-Modality and Multi-Modality Imaging Topics
Session Type:
Cartazes
FP Number:
---
Authors:
Adriana Rei Pacheco; Simão Carvalho; Diana Carvalho; Margarida Cabral; Rita Veiga; Raquel Ferreira; Rita Faria; Nuno Ferreira
Abstract
<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:"Times New Roman",serif"><span style="font-size:11.0pt"><span style="font-family:"Calibri",sans-serif">Background: The EuroSCORE II is widely embraced as a reliable system for assessing the risk of mortality in cardiac surgery. Aortic calcification is a risk marker for clinical outcomes in postoperative cardiac surgery, and recent studies suggest that this may be due to its role as a marker of the patient's overall cardiovascular risk, rather than due to aortic manipulation. Due to the risk of perioperative adverse events associated with aortic calcification, computed tomography (CT) is frequently conducted before cardiac surgery (CS).</span></span></span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:"Times New Roman",serif"><span style="font-size:11.0pt"><span style="font-family:"Calibri",sans-serif">Purpose: The objective of the study was to quantify the volume of calcium in the thoracic aorta and correlate it with preoperative risk scores, namely EuroSCORE II.</span></span></span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:"Times New Roman",serif"><span style="font-size:11.0pt"><span style="font-family:"Calibri",sans-serif">Methods: A retrospective study encompassed patients who underwent cardiac surgery and had undergone preceding CT scan. Total aortic calcification (TAC) was measured through a volume-rendering technique. Comparative analyses of demographic information, comorbidities, and clinical events were conducted between the groups.</span></span></span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:"Times New Roman",serif"><span style="font-size:11.0pt"><span style="font-family:"Calibri",sans-serif">Results: We included 148 patients, mean age 70,5±4,9, 60,8% men. The mean value of EuroSCORE II was 3,2±10,4. The mean value of the thoracic aortic calcification volume (TACV) was 2,08±2,39cm3, and the median was 1.20cm3. The sample was divided into 2 groups, according to the median of TACV: group A with TACV≤1.2cm3 and group B with TACV>1.2cm3. Group B patients were older (67.3 vs 73.7y, p<0.001) and had higher prevalence of chronic kidney disease (CKD) (GFR <60</span></span> <span style="font-size:11.0pt"><span style="font-family:"Calibri",sans-serif">ml/min/1.73m2) (p<0.001), as well as anemia (p=0.015), dyslipidemia (p=0.037) and diabetes (p=0.043). Coronary artery disease and peripheral artery disease were also more prevalent in group B (p=0.010 and p=0.016, respectively). TACV demonstrated a correlation with the occurrence of any clinical outcome during the postoperative period (p=0.036) as with the occurrence of atrial fibrillation (p=0.05). Group B patients experienced longer hospitalization (8.04 vs 13.66 days, p<0.001). When compared, patients in group B had significantly higher EuroSCORE II than patients with less TACV (1.67±1.19 vs 2.95±3.74, p<0.001).</span></span></span></span></p> <p style="text-align:justify"><span style="font-size:11.0pt"><span style="font-family:"Calibri",sans-serif">Conclusion: TACV correlates significantly with EuroSCORE II, CKD, age and postoperative events, underscoring its potential as a valuable preoperative risk marker. Notably, higher TACV aligns with prolonged hospital stays and increased susceptibility to clinical complications, emphasizing its utility in refining risk assessment and optimizing preoperative strategies for cardiac surgery patients. Whether the integration of aortic calcification into the score improves the discrimination of surgical risk remains to be clarified.</span></span></p>
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