Osaka Prognostic Score Predicts In-Hospital and One-Year Mortality Following Transcatheter Aortic Valve Implantation

Background and Objectives: Conventional risk models may not adequately capture key biological determinants of mortality following transcatheter aortic valve implantation (TAVI), such as inflammation, malnutrition, and immune dysfunction. The Osaka Prognostic Score (OPS), incorporating CRP, albumin, and lymphocyte count, may address this gap. We aimed to evaluate the prognostic value of OPS for predicting in-hospital and one-year all-cause mortality after TAVI. Materials and Methods: In this retrospective single-center cohort study, 244 patients who underwent transfemoral TAVI between December 2022 and January 2024 were analyzed. OPS was calculated at baseline (range: 0-3), and its prognostic value for in-hospital and one-year all-cause mortality was evaluated using multivariable Cox regression, ROC analysis, and restricted cubic spline (RCS) modeling. Results: In-hospital and one-year mortality rates were 11.5% and 21.7%, respectively. Higher OPS scores were significantly associated with mortality in both periods. OPS independently predicted in-hospital mortality (HR: 2.018; 95% CI: 1.632-2.521; p = 0.017) and one-year mortality (HR: 2.125; 95% CI: 1.300-3.473; p = 0.003). ROC analysis yielded AUC values of 0.776 and 0.859 for in-hospital and one-year mortality, respectively. Kaplan-Meier curves revealed significantly reduced survival in patients with higher OPS (log-rank p < 0.001), and RCS analysis demonstrated a significant nonlinear association between increasing OPS values and mortality risk (p < 0.001). Conclusions: OPS is a simple, cost-effective, and biologically relevant prognostic index that independently predicts both in-hospital and one-year mortality following TAVI. By integrating markers of inflammation, nutrition, and immune competence, OPS may offer additional value in risk stratification and support clinical decision-making in this high-risk population.