Association of PRECISE-HBR score with clinical outcomes and length of hospital stay after transcatheter aortic valve implantation.

BACKGROUND/AIM: The PRECISE-HBR score was developed to estimate bleeding risk after percutaneous coronary intervention, but its clinical utility in patients undergoing transcatheter aortic valve implantation (TAVI) remains uncertain. We evaluated its association with major bleeding and hospitalization burden after TAVI.

MATERIALS AND

METHODS

This ambispective, single-center observational study included 184 consecutive patients undergoing TAVI. The patients were categorized by PRECISE-HBR score (≤22, 23-26, and ≥27) for descriptive comparisons. Receiver operating characteristic analyses were used to assess the discriminative performance of PRECISE-HBR and the Society of Thoracic Surgeons score for major bleeding, prolonged hospitalization, and in-hospital mortality. Binary logistic regression was utilized to evaluate associations between each one-point increase in PRECISE-HBR and clinical outcomes, while correlation analyses were used to assess relationships with length of stay.

RESULTS

Higher PRECISE-HBR scores were associated with older age, female sex, hypertension, and chronic kidney disease. Major bleeding increased across score categories (7.7%, 19.4%, and 34.6%; p = 0.010) and total hospital stay was longer in the highest category (p = 0.033). PRECISE-HBR score showed weak positive correlations with intensive care unit stay (r = 0.270, p < 0.001), ward stay (r = 0.148, p = 0.044), and total hospitalization duration (r = 0.244, p = 0.001). Discrimination was moderate for major bleeding (AUC 0.748, 95% CI 0.662-0.824) and modest for prolonged hospitalization (AUC 0.615, 95% CI 0.532-0.694). Each one-point increase in PRECISE-HBR score was associated with major bleeding (OR 1.15, 95% CI 1.09-1.22; p < 0.001) and prolonged hospitalization (OR 1.06, 95% CI 1.02-1.11; p = 0.007), but not in-hospital mortality.

CONCLUSION

Higher PRECISE-HBR scores were associated with major bleeding and longer hospitalization after TAVI. The score may aid bleeding-risk assessment and estimation of hospitalization burden, although prospective external validation is required.