title: 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.
  
  
  METHODS
  Retrospective analysis of prospectively collected data.
  
  
  METHODS
  Intensive care unit in a tertiary-care hospital.
  
  
  METHODS
  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.
  
  
  METHODS
  none.
  
  
  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.
authors: Departments of Anesthesiology, Intensive Care and Pain Medicine.
authors: Thijs C D
authors: TC
authors: Rettig
authors: Departments of Anesthesiology, Intensive Care and Pain Medicine.
authors: Sander
authors: S
authors: Rigter
authors: Cardiology.
authors: Vincent J
authors: VJ
authors: Nijenhuis
authors: Cardiology.
authors: Jan-Peter
authors: JP
authors: van Kuijk
authors: Cardiology.
authors: Jurriën M
authors: JM
authors: ten Berg
authors: Cardiothoracic Surgery.
authors: Robin H
authors: RH
authors: Heijmen
authors: Clinical Pharmacy, St. Antonius Hospital, Nieuwegein, The Netherlands.
authors: Ewoudt M W
authors: EM
authors: van de Garde
authors: Departments of Anesthesiology, Intensive Care and Pain Medicine. Electronic address: p.noordzij@antoniusziekenhuis.nl.
authors: Peter G
authors: PG
authors: Noordzij
mesh_terms: D058186:Acute Kidney Injury / Q000453:epidemiology; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D010043:Outcome and Process Assessment, Health Care / Q000706:statistics & numerical data*; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D018746:Systemic Inflammatory Response Syndrome / Q000453:epidemiology*
keywords: acute kidney injury; aortic valve; cardiac surgical procedure; mortality; systemic inflammatory response syndrome; treatment outcome