Predicting Short- and Long-Term Outcomes in Adult Heart Transplantation: Clinical Utility of MELD-XI Score
| Autor: | D. Lora-Pablos, M. D. García-Cosio, Fernando Arribas-Ynsaurriaga, Juan Delgado-Jiménez, Adriana Rodríguez-Chaverri, José M. Cortina-Romero, Carlos Ortiz-Bautista, Laura Morán-Fernández, J. De Juan-Baguda, E. Pérez-de la Sota, I. Ponz-de Antonio |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_specialty Prognostic variable medicine.medical_treatment 030204 cardiovascular system & hematology Severity of Illness Index 03 medical and health sciences chemistry.chemical_compound Liver disease 0302 clinical medicine Internal medicine Severity of illness medicine Humans 030212 general & internal medicine Retrospective Studies Heart transplantation Transplantation Creatinine Framingham Risk Score business.industry Mortality rate Retrospective cohort study Middle Aged Prognosis medicine.disease body regions chemistry Heart Transplantation Female Surgery business |
| Zdroj: | Transplantation Proceedings. 50:3710-3714 |
| ISSN: | 0041-1345 |
| DOI: | 10.1016/j.transproceed.2018.08.030 |
| Popis: | Model for End-Stage Liver Disease scoring system excluding international normalized ratio (MELD-XI) has been related with worse outcomes after heart transplantation (HT). However, according to standards in prognostic models research, before implementing a risk score for daily clinical decision-making, its performance and impact on clinical practice/outcomes should be evaluated. The aim of this study was to evaluate the ability of the MELD-XI score to predict outcomes in daily clinical practice.We retrospectively reviewed 190 consecutive adults undergoing HT between 2005-2015. Patients were stratified into low (MELD-XI 12) and high (MELD-XI ≥12) risk cohorts. Mortality rates at 30 days and 1 year were compared between MELD-XI groups. MELD-XI ability to predict 1-year mortality was assessed by the area under the receiver operating curve (AUC) and compared to that of bilirubin, creatinine, and pulmonary vascular resistance (PVR).Mortality rates at 30 days and 1 year were similar between groups (8% vs 13%; P = .28 and 21% vs 29%; P = .21, respectively). MELD-XI ability to predict 1-year mortality was poor and similar to that of bilirubin, creatinine, and PVR (0.51 vs 0.47 vs 0.50 vs 0.50, respectively).MELD-XI score utility in HT clinical decision-making is scarce since its discrimination ability is poor and similar to other simple prognostic variables. |
| Databáze: | OpenAIRE |
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