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Predicting Short- and Long-Term Outcomes in Adult Heart Transplantation: Clinical Utility of MELD-XI Score.

Abstract：

BACKGROUND: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. MATERIAL AND METHODS: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). RESULTS: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). CONCLUSIONS:MELD-XI score utility in HT clinical decision-making is scarce since its discrimination ability is poor and similar to other simple prognostic variables.

journal_name

Transplant Proc

journal_title

Transplantation proceedings

authors

Ortiz-Bautista C,García-Cosio MD,Lora-Pablos D,Ponz-de Antonio I,Rodríguez-Chaverri A,Morán-Fernández L,de Juan-Bagudá J,Pérez-de la Sota E,Cortina-Romero JM,Arribas-Ynsaurriaga F,Delgado-Jiménez JF

doi

10.1016/j.transproceed.2018.08.030

subject

Has Abstract

pub_date

2018-12-01 00:00:00

pages

3710-3714

issue

10

eissn

0041-1345

issn

1873-2623

pii

S0041-1345(18)31021-2

journal_volume

50

pub_type

杂志文章

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