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External validation of the Vascular Quality Initiative prediction model for survival in no-option chronic limb-threatening ischemia patients.

Abstract：

OBJECTIVE:Chronic limb-threatening ischemia (CLTI) is associated with high morbidity and mortality rates. More than 50% of all CLTI patients die within 5 years after presentation. Patient-specific survival prediction is critical for informing treatment strategies, even for those without a clear option for revascularization. We validated a survival prediction model, developed in a revascularized Vascular Quality Initiative (VQI) cohort, in a Western European no-option CLTI cohort. METHODS:The VQI survival prediction model was applied to the validation cohort (N = 150) to compare estimated mortality and observed mortality at 2 years after baseline. Performance of the VQI model was tested by evaluating discrimination using the receiver operating characteristic area under the curve and calibration using the Hosmer-Lemeshow goodness-of-fit test. RESULTS:The 2-year survival rate was 79% in the validation cohort compared with 83% in the VQI cohort. Baseline characteristics were significantly different for 13 of 17 variables. The C statistic was 0.86 (95% confidence interval, 0.78-0.95), which indicates good discrimination. The Hosmer-Lemeshow goodness-of-fit test had a P value of .30, which indicates good fit. CONCLUSIONS:This is the first external validation of the VQI survival prediction model. The good model performance suggests that this model can be used in different CLTI populations, including no-option CLTI, and underlines its contributory role in this challenging population.

journal_name

J Vasc Surg

journal_title

Journal of vascular surgery

authors

Verwer MC,Wijnand JGJ,Teraa M,Gremmels H,Simons JP,Conte MS,Verhaar MC,de Borst GJ

doi

10.1016/j.jvs.2020.02.018

subject

Has Abstract

pub_date

2020-11-01 00:00:00

pages

1659-1666.e1

issue

5

eissn

0741-5214

issn

1097-6809

pii

S0741-5214(20)30290-1

journal_volume

72

pub_type

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