Derivation and validation of the bridge to transplantation with left ventricular assist device score for 1 year mortality after heart transplantation. The BTT-LVAD score

Background: To derive and validate a risk score that accurately predicts 1-year mortality after heart transplantation (HT) in patients bridged to transplant (BTT) with a left ventricular assist device (LVAD). Methods: The UNOS database was queried to identify patients BTT with an LVAD between 2008 a...

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Published in:International journal of artificial organs 2022-05, Vol.45 (5), p.470-477
Main Authors: Okoh, Alexis K, Fugar, Setri, Dodoo, Sheriff, Selevany, Mariam, Al-Obaidi, Nawar, Ozturk, Ebru, Singh, Swaiman, Tayal, Rajiv, Lee, Leonard Y, Russo, Mark J, Camacho, Margarita
Format: Article
Language:English
Subjects:
Congestive heart failure
Derivation
Heart Failure - surgery
Heart transplantation
Heart Transplantation - adverse effects
Heart-Assist Devices
Humans
Mortality
Patients
Rank tests
Retrospective Studies
Risk
Risk Factors
Risk groups
Transplantation
Transplants & implants
Treatment Outcome
Ventricle
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Summary:Background: To derive and validate a risk score that accurately predicts 1-year mortality after heart transplantation (HT) in patients bridged to transplant (BTT) with a left ventricular assist device (LVAD). Methods: The UNOS database was queried to identify patients BTT with an LVAD between 2008 and 2018. Patients with ⩾1-year follow up were randomly divided into derivation (70%) and validation (30%) cohorts. The primary endpoint was 1-year mortality. A simple additive risk score was developed based on the odds of 1-year mortality after HT. Risk groups were created, and survival was estimated and compared. Results: A total of 7759 patients were randomly assigned to derivation (n = 5431) and validation (n = 2328) cohorts. One-year post-transplant mortality was 9.8% (n = 760). A 33-point scoring was created from six recipient variables and two donor variables. Risk groups were classified as low (0–5), intermediate (6–10), and high (>10). In the validation cohort, the predicted 1-year mortality was significantly higher in the high-risk group than the intermediate and low-risk groups, 14.7% versus 9% versus 6.1% respectively (log-rank test: p 
ISSN:0391-3988
1724-6040
DOI:10.1177/03913988221082690