PMID- 19932256
OWN - NLM
STAT- MEDLINE
DCOM- 20100105
LR  - 20101118
IS  - 1552-6259 (Electronic)
IS  - 0003-4975 (Linking)
VI  - 88
IP  - 6
DP  - 2009 Dec
TI  - Evaluation of risk indices in continuous-flow left ventricular assist device 
      patients.
PG  - 1889-96
LID - 10.1016/j.athoracsur.2009.08.011 [doi]
AB  - BACKGROUND: The Leitz-Miller (LM), Columbia (COL), Acute Physiology and Chronic 
      Health Evaluation II (APACHE II), Interagency Registry for Mechanically Assisted 
      Circulatory Support (INTERMACS), and Seattle Heart Failure Model (SHFM) risk 
      scores have been used to risk stratify patients with pulsatile-flow left 
      ventricular assist devices (LVAD). We assessed the predictive ability of these 
      scores in a cohort of continuous-flow LVAD patients. METHODS: Preoperative scores 
      were calculated from prospective data of patients who received continuous-flow 
      LVADs between June 2000 and May 2009. Cox proportional hazard analysis assessed 
      the effect of preoperative variables and scores on 30-day, 90-day, and 1-year 
      mortality. Patients were stratified by score into low- and high-risk groups. 
      Survival was modeled using the Kaplan-Meier method. RESULTS: During the study 
      period, 86 continuous-flow LVADs were implanted. The mean (+/- standard 
      deviation) preoperative scores were: COL, 1.05 +/- 1.59; LM, 11.9 +/- 5.4; APACHE 
      II, 15.6 +/- 4.3; INTERMACS, 2.64 +/- 1.01; and SHFM, 2.97 +/- 1 .42. On 
      univariate analysis, the SHFM score best differentiated low- and high-risk 
      patients at all mortality end points; the INTERMACS and APACHE II scores were 
      predictive for 90-day and 1-year mortality. On multivariable analysis, SHFM 
      (hazard ratio [HR], 1.50; 95% confidence interval [CI], 1.02 to 2.21; p = 0.04) 
      and APACHE II (HR, 1.10; 95% CI, 1.01 to 1.21; p = 0.04) predicted 1-year 
      mortality. CONCLUSIONS: Among the LM, COL, APACHE II, INTERMACS, and SHFM scores, 
      the best predictor of mortality in a single institutional cohort of 
      continuous-flow LVAD patients was the SHFM score.
FAU - Schaffer, Justin M
AU  - Schaffer JM
AD  - Division of Cardiac Surgery, Department of Surgery, The Johns Hopkins Medical 
      Institutions, Baltimore, Maryland 21287, USA.
FAU - Allen, Jeremiah G
AU  - Allen JG
FAU - Weiss, Eric S
AU  - Weiss ES
FAU - Patel, Nishant D
AU  - Patel ND
FAU - Russell, Stuart D
AU  - Russell SD
FAU - Shah, Ashish S
AU  - Shah AS
FAU - Conte, John V
AU  - Conte JV
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - Netherlands
TA  - Ann Thorac Surg
JT  - The Annals of thoracic surgery
JID - 15030100R
SB  - IM
MH  - APACHE
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Failure/mortality/*surgery
MH  - *Heart-Assist Devices
MH  - Humans
MH  - Kaplan-Meier Estimate
MH  - Male
MH  - Middle Aged
MH  - Prognosis
MH  - Proportional Hazards Models
MH  - Retrospective Studies
MH  - Risk Assessment/*methods
MH  - Risk Factors
MH  - Survival Rate/trends
MH  - United States/epidemiology
EDAT- 2009/11/26 06:00
MHDA- 2010/01/06 06:00
CRDT- 2009/11/26 06:00
PHST- 2009/03/07 00:00 [received]
PHST- 2009/08/04 00:00 [revised]
PHST- 2009/08/06 00:00 [accepted]
PHST- 2009/11/26 06:00 [entrez]
PHST- 2009/11/26 06:00 [pubmed]
PHST- 2010/01/06 06:00 [medline]
AID - S0003-4975(09)01608-7 [pii]
AID - 10.1016/j.athoracsur.2009.08.011 [doi]
PST - ppublish
SO  - Ann Thorac Surg. 2009 Dec;88(6):1889-96. doi: 10.1016/j.athoracsur.2009.08.011.