Prediction of Waitlist Mortality in Adult Heart Transplant Candidates: The Candidate Risk Score.
Jasseron C, Legeai C, et al.Transplantation 2017 [record in progress].
Aims
To generate and validate a risk score in heart transplant candidates that predicts 1-year waitlist mortality or delisting for worsening medical condition based on candidate variables.
Interventions
Participants were randomly divided into a derivation and validation cohort and variables associated with the outcomes on the waiting list were analysed to generate a candidate risk score.
Participants
2333 adult patients aged ≥ 16 years of age on the French national waiting list for first, single-organ heart transplantation.
Outcomes
The primary outcome measured was 1-year waitlist mortality or delisting for worsening medical condition. Other outcomes measured included candidate demographics, primary diagnosis, clinical status, device therapy, and, laboratory parameters at listing.
Follow-up
1 year
CET Conclusions
This cohort analysis using the French registry database CRISTAL aimed to develop a heart transplant candidate risk score to predict 1-year waitlist mortality or delisting due to worsening medical condition. The population of 2333 adult, first, single-organ heart transplantation candidates was randomly divided in a derivation (67%) and validation cohort (33%). Thirteen percent of patients died or were delisted and 1-year survival on the waiting list was 79%. In the univariate model 22 candidate characteristics were associated with the 1-year mortality or delisting of which 7 remained significant in the multivariate model. A simplified model of four commonly reported characteristics was built and this was used to produce the candidate risk score. The study found a strong correlation between the observed and predicted 1-year waitlist mortality.
Quality notes
Quality assessment not appropriate.
Trial registration
None