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July 18, 2026Canadian Journal of CardiologyOpen Access

SALZBURG Score predicts 3-year post-TAVI mortality with a 0.66 AUC, outperforming EuroSCORE II and STS.

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Why the study?

Does the SALZBURG Score improve prediction of 3-year all-cause mortality in patients undergoing transfemoral TAVI compared to established risk scores?

Population

702 consecutive patients undergoing transfemoral transcatheter aortic valve implantation with self-expanding…

Comparison

SALZBURG Score for risk stratification vs Established risk scores

Design

Cohort

Follow-up

3 years

Key result

The SALZBURG Score predicted 3-year mortality after transfemoral TAVI with an AUC of 0.66 (95% CI 0.61-0.71), outperforming EuroSCORE II and the STS Score.

Authors

EBElke BoxhammerNCNikolaus ClodiRRRichard Rezar

Discussion

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Overview

Should not yet change TAVI risk stratification; leaves open external validation of the SALZBURG Score.

Key Points

  • The aim is to develop and validate a simple score for predicting long-term mortality after transfemoral TAVI.
  • Conducted a multi-center study with 585 patients for score derivation and 117 patients for external validation.
  • Identified mortality predictors using LASSO-Cox regression and multivariable Cox modeling.
  • Assessed model performance using discrimination, calibration, and decision curve analysis.
  • The SALZBURG Score predicted 3-year mortality with an AUC of 0.66, outperforming EuroSCORE II (AUC 0.56, p=0.002).
  • Discrimination remained stable in the external validation cohort with a C-index of 0.62.
  • Calibration was good across predefined risk groups, improving risk reclassification compared to established models.

Study Design

Type

Cohort (n=702)

Multicenter

Yes

Structured PICO

Does the SALZBURG Score improve prediction of 3-year all-cause mortality in patients undergoing transfemoral TAVI compared to established risk scores?

P
Population
702 consecutive patients undergoing transfemoral TAVI with self-expanding valve systems, evaluated for 3-year mortality risk.
E
Exposure
SALZBURG Score (0-11 points, incorporating age >80 years, male sex, eGFR <60 ml/min, atrial fibrillation, anemia, and diabetes mellitus) for risk stratification
C
Comparator
Established risk scores (EuroSCORE II, STS Score, TAVR-Risk Score, TAVI2-SCORe)
O
Outcome
3-year all-cause mortalityhard clinical

Main Result

Effect estimate: AUC 0.66 (95% CI 0.61-0.71)

The SALZBURG Score is a simple, externally validated bedside tool that outperforms several established surgical and TAVI-specific risk models in predicting 3-year mortality after transfemoral TAVI.

Limitations

  • Pending validation in larger contemporary TAVI cohorts

Cite This Study

Boxhammer et al. (2026) conducted a cohort in Transfemoral transcatheter aortic valve implantation (TAVI) (n=702). SALZBURG Score vs. EuroSCORE II, STS Score, TAVR-Risk Score, and TAVI2-SCORe was evaluated on 3-year all-cause mortality (AUC 0.66, 95% CI 0.61-0.71). The SALZBURG Score predicted 3-year mortality after transfemoral TAVI with an AUC of 0.66 (95% CI 0.61-0.71), outperforming EuroSCORE II and the STS Score.

synapsesocial.com/papers/6a5b38f68167787360d24df9https://doi.org/10.1016/j.cjca.2026.07.008
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