Novel Risk Scoring System With Preoperative Objective Parameters Gives a Good Prediction of 1-Year Mortality in Patients With a Left Ventricular Assist Device

• Published in: Circulation Journal 2012, Vol.76(8), pp.1895-1903
• Main Authors: Imamura, Teruhiko, Kinugawa, Koichiro, Shiga, Taro, Endo, Miyoko, Kato, Naoko, Inaba, Toshiro, Maki, Hisataka, Hatano, Masaru, Yao, Atsushi, Nishimura, Takashi, Hirata, Yasunobu, Kyo, Shunei, Ono, Minoru, Nagai, Ryozo
• Format: Article
• Language: English
• Subjects: Adult; Bilirubin - blood; Continuous flow; Female; Follow-Up Studies; Heart failure; Heart Failure - blood; Heart Failure - mortality; Heart Failure - therapy; Heart-Assist Devices; Humans; Male; Middle Aged; Prognosis; Right ventricular dysfunction; Risk Assessment; Serum Albumin - metabolism; Survival Rate
• ISSN: 1346-9843; 1347-4820; 1347-4820
• DOI: 10.1253/circj.CJ-12-0182

Background: As we have previously reported, the preoperative profile defined by INTERMACS is a good predictor for the prognosis after left ventricular assist device (LVAD) implantation, but is largely dependent on the physician’s decision. Several other risk stratification systems including objective parameters (eg, Leitz-Miller, Columbia, Seattle Heart Failure Model, APACHE II) have been proposed to estimate patient’s mortality after LVAD implantation. Methods and Results: According to the preoperative data from 59 patients who received LVAD (10 implantable, 49 extracorporeal) since 2002 through 2010, we performed a logistic analysis and constructed a new scoring system (ie, the TODAI VAD score (TVAD score), assigning 8 points to serum albumin 4.8mg/dl (OR 7.300), 6 points to left ventricular end-diastolic diameter 11mmHg (OR 5.128)). The receiver-operating characteristic analysis showed that the area under the curve of our new scoring system (0.864) was significantly larger than any of the abovementioned 5 scoring methods (all P