A Risk Score for Adults With Congenital Heart Disease Undergoing Heart Transplantation

This study derived and validated a risk score for 1-year mortality in patients with adult congenital heart disease (ACHD) undergoing orthotopic heart transplantation (OHT). The United Network for Organ Sharing registry identified patients with ACHD (≥18 years of age) who underwent OHT between 1987 a...

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Veröffentlicht in:The Annals of thoracic surgery 2021-06, Vol.111 (6), p.2033-2040
Hauptverfasser: Seese, Laura, Morell, Victor O., Viegas, Melita, Keebler, Mary, Hickey, Gavin, Wang, Yisi, Kilic, Arman
Format: Artikel
Sprache:eng
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Zusammenfassung:This study derived and validated a risk score for 1-year mortality in patients with adult congenital heart disease (ACHD) undergoing orthotopic heart transplantation (OHT). The United Network for Organ Sharing registry identified patients with ACHD (≥18 years of age) who underwent OHT between 1987 and 2018. The primary outcome was 1-year mortality. Associated covariates (univariate P < .2) were entered into a multivariable logistic regression model. Variable inclusion in the model was assessed by improvement in the McFadden pseudo-R2, likelihood ratio test, and C-index. A risk score was created using the absolute magnitude of the odds ratios from the derivation cohort, and its ability to predict 1-year mortality was tested in the validation cohort. A total of 1388 recipients were randomly divided into derivation (66.7%, n = 950) and validation (33.3%, n = 438) cohorts. A 13-point risk score incorporating 4 pretransplant variables (age, dialysis dependence, serum bilirubin level, and mechanical ventilation) was created. The predicted 1-year mortality ranged from 14.6% (0 points) to 49.9% (13 points) (P 
ISSN:0003-4975
1552-6259
DOI:10.1016/j.athoracsur.2020.05.154