{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T23:22:30Z","timestamp":1790032950917,"version":"4.0.1"},"reference-count":34,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2025,9,12]],"date-time":"2025-09-12T00:00:00Z","timestamp":1757635200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Preoperative systemic inflammation and nutritional status are known to affect prognosis and length of hospital stay (LoS) in patients undergoing transcatheter aortic valve replacement (TAVR). The Naples Prognostic Score (NPS) is a simple and effective scoring system that assesses both nutrition and inflammation, and has been shown to predict prognosis in various clinical settings. We aimed to determine the effect of NPS on LoS in patients undergoing TAVR. Materials and Methods: A total of 405 patients who underwent TAVR were retrospectively divided into two groups based on length of stay: early discharge (LoS \u2264 3 days) and late discharge (LoS &gt; 3 days). The NPS was calculated prior to the TAVR procedure. Results: In the late discharge group (n = 164, 40.6%), patients were found to have significantly higher values for age, NYHA functional class, STS risk score, systolic pulmonary artery pressure, white blood cell count, neutrophil count, monocyte count, creatinine, glucose, NLR, rate of surgical access site, incidence of major\/minor access site and structural complications, myocardial infarction, cerebrovascular events, acute kidney injury, major bleeding, blood transfusion, pacemaker implantation, and elevated NPS (p &lt; 0.05). When independent risk factors for late discharge were evaluated, in addition to reduced eGFR, surgical closure of the access site, history of cerebrovascular events, need for pacemaker implantation, and blood transfusion, a high Naples Prognostic Score was also identified as an independent risk factor for prolonged hospital stay after TAVR in the multivariate logistic regression analysis (p &lt; 0.05). Conclusions: A high Naples Prognostic Score (NPS), which reflects systemic inflammation and nutritional status, is associated with delayed hospital discharge and is an independent risk factor in patients undergoing TAVR.<\/jats:p>","DOI":"10.3390\/medicina61091658","type":"journal-article","created":{"date-parts":[[2025,9,12]],"date-time":"2025-09-12T07:52:28Z","timestamp":1757663548000},"page":"1658","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Predictors of Length of Stay in Hospital After Transcatheter Aortic Valve Replacement: Impact of Naples Prognostic Score"],"prefix":"10.3390","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3125-9328","authenticated-orcid":false,"given":"Faruk","family":"Boyac\u0131","sequence":"first","affiliation":[{"name":"Department of Cardiology, Samsun Education and Research Hospital, Samsun University, 55090 Samsun, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4610-8514","authenticated-orcid":false,"given":"Murat","family":"Akcay","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Faculty of Medicine, Ondokuz May\u0131s University, 55139 Samsun, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3490-6009","authenticated-orcid":false,"given":"Mustafa Kursat","family":"Sahin","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, Faculty of Medicine, Ondokuz May\u0131s University, 55139 Samsun, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0933-7852","authenticated-orcid":false,"given":"Mustafa","family":"Yenercag","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Samsun Education and Research Hospital, Samsun University, 55090 Samsun, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3548-1276","authenticated-orcid":false,"given":"Ahmet","family":"Karagoz","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Samsun Education and Research Hospital, Samsun University, 55090 Samsun, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3488-5372","authenticated-orcid":false,"given":"Ahmet","family":"Yanik","sequence":"additional","affiliation":[{"name":"Clinic of Cardiology, Samsun Medicina Hospital, 55080 Samsun, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8995-0480","authenticated-orcid":false,"given":"Serkan","family":"Sivri","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Samsun Education and Research Hospital, Samsun University, 55090 Samsun, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0587-3356","authenticated-orcid":false,"given":"Rustem","family":"Yilmaz","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Samsun Education and Research Hospital, Samsun University, 55090 Samsun, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-0854-385X","authenticated-orcid":false,"given":"Berkant","family":"Ozturk","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Samsun Education and Research Hospital, Samsun University, 55090 Samsun, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-2713-0712","authenticated-orcid":false,"given":"Halil Ibrahim","family":"Kokcu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Samsun Education and Research Hospital, Samsun University, 55090 Samsun, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-8335-6243","authenticated-orcid":false,"given":"Enes","family":"Kaya","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Samsun Education and Research Hospital, Samsun University, 55090 Samsun, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-9172-4473","authenticated-orcid":false,"given":"Okan Oguzhan","family":"Ovaz","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Samsun Education and Research Hospital, Samsun University, 55090 Samsun, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdalrahman Shawky Abdalrahman","family":"Mostafa","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Samsun Education and Research Hospital, Samsun University, 55090 Samsun, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-8708-6204","authenticated-orcid":false,"given":"Emre Kasim","family":"Yilmaz","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Samsun Education and Research Hospital, Samsun University, 55090 Samsun, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,9,12]]},"reference":[{"key":"ref_1","first-page":"e35","article-title":"2020 ACC\/AHA Guideline for the Management of Patients With Valvular Heart Disease: Executive Summary: A Report of the American College of Cardiology\/American Heart Association Joint Committee on Clinical Practice Guidelines","volume":"143","author":"Otto","year":"2021","journal-title":"Circulation"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1093\/eurheartj\/ehab395","article-title":"2021 ESC\/EACTS Guidelines for the management of valvular heart disease","volume":"43","author":"Vahanian","year":"2022","journal-title":"Eur. Heart J."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1007\/s00392-020-01647-4","article-title":"Analysis of length of stay after transfemoral transcatheter aortic valve replacement: Results from the FRANCE TAVI registry","volume":"110","author":"Durand","year":"2021","journal-title":"Clin. Res. Cardiol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"422","DOI":"10.1016\/j.jcin.2018.11.015","article-title":"Length of Stay After Transfemoral Transcatheter Aortic Valve Replacement: An Analysis of the Society of Thoracic Surgeons\/American College of Cardiology Transcatheter Valve Therapy Registry","volume":"12","author":"Wayangankar","year":"2019","journal-title":"JACC Cardiovasc. Interv."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"903","DOI":"10.1016\/S0003-4975(97)00017-9","article-title":"The Society of Thoracic Surgeons National Cardiac Surgery Database: Current risk assessment","volume":"63","author":"Edwards","year":"1997","journal-title":"Ann. Thorac. Surg."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1016\/S1010-7940(99)00134-7","article-title":"European system for cardiac operative risk evaluation (EuroSCORE)","volume":"16","author":"Nashef","year":"1999","journal-title":"Eur. J. Cardiothorac. Surg."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"e026294","DOI":"10.1161\/JAHA.122.026294","article-title":"Prevalence and Prognostic Significance of Malnutrition in Older Japanese Adults at High Surgical Risk Undergoing Transcatheter Aortic Valve Implantation","volume":"11","author":"Ishizu","year":"2022","journal-title":"J. Am. Heart Assoc."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1007\/s00392-023-02220-5","article-title":"A simply calculated nutritional index provides clinical implications in patients undergoing transcatheter aortic valve replacement","volume":"113","author":"Sudo","year":"2024","journal-title":"Clin. Res. Cardiol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"770","DOI":"10.1016\/j.amjcard.2016.11.019","article-title":"Prognostic Value of Hypoalbuminemia After Transcatheter Aortic Valve Implantation (from the Japanese Multicenter OCEAN-TAVI Registry)","volume":"119","author":"Yamamoto","year":"2017","journal-title":"Am. J. Cardiol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"2597","DOI":"10.1002\/ehf2.12837","article-title":"Inflammatory signatures are associated with increased mortality after transfemoral transcatheter aortic valve implantation","volume":"7","author":"Hoffmann","year":"2020","journal-title":"ESC Heart Fail."},{"key":"ref_11","first-page":"e77909","article-title":"The Prognostic Value of Neutrophil-to-Lymphocyte Ratio on Mortality in Patients Undergoing Transcatheter Aortic Valve Implantation: A Systematic Review and Meta-Analysis","volume":"17","author":"Rawat","year":"2025","journal-title":"Cureus"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1273","DOI":"10.1097\/DCR.0000000000000961","article-title":"Naples Prognostic Score, Based on Nutritional and Inflammatory Status, is an Independent Predictor of Long-term Outcome in Patients Undergoing Surgery for Colorectal Cancer","volume":"60","author":"Galizia","year":"2017","journal-title":"Dis. Colon. Rectum."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"2442536","DOI":"10.1080\/07853890.2024.2442536","article-title":"The importance of Naples prognostic score in predicting long-term mortality in heart failure patients","volume":"57","author":"Aydin","year":"2025","journal-title":"Ann. Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"970","DOI":"10.1177\/00033197231151559","article-title":"Impact of Naples Prognostic Score at Admission on In-Hospital and Follow-Up Outcomes Among Patients with ST-Segment Elevation Myocardial Infarction","volume":"74","author":"Erdogan","year":"2023","journal-title":"Angiology"},{"key":"ref_15","first-page":"287","article-title":"The performance of the NAPLES prognostic score in predicting one-year mortality and major adverse cardiovascular events after transcatheter aortic valve implantation in patients with severe aortic stenosis","volume":"83","author":"Gitmez","year":"2025","journal-title":"Kardiol. Pol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"519","DOI":"10.2459\/JCM.0000000000001637","article-title":"The impact of the Naples Prognostic Score on the short- and long-term prognosis of patients undergoing transcatheter aortic valve implantation","volume":"25","author":"Hakgor","year":"2024","journal-title":"J. Cardiovasc. Med."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Varc-3 Writing, C., Genereux, P., Piazza, N., Alu, M.C., Nazif, T., Hahn, R.T., Pibarot, P., Bax, J.J., Leipsic, J.A., and Blanke, P. (2021). Valve Academic Research Consortium 3: Updated Endpoint Definitions for Aortic Valve Clinical Research. J. Am. Coll. Cardiol., 77, 2717\u20132746.","DOI":"10.1016\/j.jacc.2021.02.038"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"2492","DOI":"10.1016\/j.jacc.2020.09.595","article-title":"STS-ACC TVT Registry of Transcatheter Aortic Valve Replacement","volume":"76","author":"Carroll","year":"2020","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"e494","DOI":"10.4244\/EIJ-D-19-01080","article-title":"Predictors and safety of next-day discharge in patients undergoing transfemoral transcatheter aortic valve implantation","volume":"16","author":"Costa","year":"2020","journal-title":"EuroIntervention"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1179","DOI":"10.1007\/s11886-022-01737-x","article-title":"Update on Minimalist TAVR Care Pathways: Approaches to Care in 2022","volume":"24","author":"Sawan","year":"2022","journal-title":"Curr. Cardiol. Rep."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"689","DOI":"10.1016\/j.jacc.2017.06.024","article-title":"Frailty in Older Adults Undergoing Aortic Valve Replacement: The FRAILTY-AVR Study","volume":"70","author":"Afilalo","year":"2017","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_22","first-page":"123","article-title":"The relationship between preoperative frailty and outcomes following transcatheter aortic valve implantation: A systematic review and meta-analysis","volume":"3","author":"Anand","year":"2017","journal-title":"Eur. Heart J. Qual. Care Clin. Outcomes"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"577","DOI":"10.1002\/jcsm.12689","article-title":"Frailty in patients undergoing transcatheter aortic valve replacement: Prognostic value of the Geriatric Nutritional Risk Index","volume":"12","author":"Seoudy","year":"2021","journal-title":"J. Cachexia Sarcopenia Muscle"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1007\/s00392-019-01497-9","article-title":"Nutritional status and risk of all-cause mortality in patients undergoing transcatheter aortic valve replacement assessment using the geriatric nutritional risk index and the controlling nutritional status score","volume":"109","author":"Lee","year":"2020","journal-title":"Clin. Res. Cardiol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"312","DOI":"10.5603\/CJ.a2019.0038","article-title":"Nutritional risk index is a better predictor of early mortality than conventional nutritional markers after transcatheter aortic valve replacement: A prospective cohort study","volume":"28","author":"Papadopoulos","year":"2021","journal-title":"Cardiol. J."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1016\/j.ejim.2018.04.014","article-title":"Human serum albumin in cardiovascular diseases","volume":"52","author":"Arques","year":"2018","journal-title":"Eur. J. Intern. Med."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Wleklik, M., Denfeld, Q., Lisiak, M., Czapla, M., Kaluzna-Oleksy, M., and Uchmanowicz, I. (2022). Frailty Syndrome in Older Adults with Cardiovascular Diseases-What Do We Know and What Requires Further Research?. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph19042234"},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Czapla, M., Juarez-Vela, R., Lokiec, K., and Karniej, P. (2021). The Association between Nutritional Status and In-Hospital Mortality among Patients with Heart Failure-A Result of the Retrospective Nutritional Status Heart Study 2 (NSHS2). Nutrients, 13.","DOI":"10.3390\/nu13051669"},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Czapla, M., Juarez-Vela, R., Lokiec, K., Wleklik, M., Karniej, P., and Smereka, J. (2022). The Association between Nutritional Status and Length of Hospital Stay among Patients with Hypertension. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph19105827"},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Czapla, M., Uchmanowicz, I., Juarez-Vela, R., Durante, A., Kaluzna-Oleksy, M., Lokiec, K., Baeza-Trinidad, R., and Smereka, J. (2022). Relationship between nutritional status and length of hospital stay among patients with atrial fibrillation\u2014A result of the nutritional status heart study. Front. Nutr., 9.","DOI":"10.3389\/fnut.2022.1086715"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"72","DOI":"10.4103\/aca.aca_114_21","article-title":"Pre-procedural serum albumin concentration is associated with length of stay, discharge destination, and 90-day mortality in patients after transcatheter aortic valve replacement","volume":"26","author":"Beydoun","year":"2023","journal-title":"Ann. Card. Anaesth."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1340","DOI":"10.1016\/j.hlc.2024.03.013","article-title":"Post-Procedure Monocyte Count Levels Predict Major Adverse Cardiovascular Events (MACE) Following Transcatheter Aortic Valve Implantation (TAVI) for Aortic Stenosis","volume":"33","author":"Navani","year":"2024","journal-title":"Heart Lung Circ."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"675","DOI":"10.1080\/17520363.2024.2389035","article-title":"Naples prognostic score as a predictor of mortality in surgical aortic valve replacement","volume":"18","author":"Erdogan","year":"2024","journal-title":"Biomark. Med."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"175","DOI":"10.3390\/prosthesis6010014","article-title":"Risk of Bleeding in Elderly Patients Undergoing Transcatheter Aortic Valve Implantation or Surgical Aortic Valve Replacement","volume":"6","author":"Jiritano","year":"2024","journal-title":"Prosthesis"}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/61\/9\/1658\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:44:19Z","timestamp":1760035459000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/61\/9\/1658"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,12]]},"references-count":34,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2025,9]]}},"alternative-id":["medicina61091658"],"URL":"https:\/\/doi.org\/10.3390\/medicina61091658","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,12]]}}}