The Ability of Comorbidity Indices to Predict Mortality After Heart Transplantation: A Validation of the Danish Comorbidity Index for Acute Myocardial Infarction, Charlson Comorbidity Index, and Elixhauser Comorbidity Index

Transplantation Direct

article

Kasper Bonnesen¹  Rikke E. Mols²  Brian Løgstrup²  Finn Gustafsson⁴  Hans Eiskjær²  Morten Schmidt¹ 

[1]Department of Clinical Epidemiology, Aarhus University and Aarhus University Hospital

[2]Department of Clinical Medicine, Aarhus University

[3]Department of Cardiology, Aarhus University Hospital

[4]Department of Clinical Medicine, Copenhagen University

[5]Department of Cardiology, Rigshospitalet

DOI  :  10.1097/TXD.0000000000001438

学科分类：社会科学、人文和艺术（综合）

来源: Wolters Kluwer

【 摘 要 】

Background  Advanced heart failure patients often have comorbidities of prognostic importance. However, whether total pretransplantation comorbidity burden predicts mortality in patients treated with heart transplantation (HTx) is unknown. We used population-based hospital and prescription data to examine the ability of the Danish Comorbidity Index for Acute Myocardial Infarction (DANCAMI), DANCAMI restricted to noncardiovascular diseases, Charlson Comorbidity Index, and Elixhauser Comorbidity Index to predict 30-d, 1-y, 5-y, and 10-y all-cause and cardiovascular mortality after HTx. Methods  We identified all adult Danish patients with incident HTx from the Scandiatransplant Database between March 1, 1995, and December 31, 2018 (n = 563). We calculated Harrell’s C-Statistics to examine discriminatory performance. Results  The C-Statistic for predicting 1-y all-cause mortality after HTx was 0.58 (95% confidence interval [CI], 0.50-0.65) for a baseline model including age and sex. Adding comorbidity score to the baseline model did not increase the C-Statistics for DANCAMI (0.58; 95% CI, 0.50-0.65), DANCAMI restricted to noncardiovascular diseases (0.57; 95% CI, 0.50-0.64), Charlson Comorbidity Index (0.59; 95% CI, 0.51-0.66), or Elixhauser Comorbidity Index (0.58; 95% CI, 0.51-0.65). The results for 30-d, 5-y, and 10-y all-cause and cardiovascular mortality were consistent. Conclusions.  After accounting for patient age and sex, none of the commonly used comorbidity indices added predictive value to short- or long-term all-cause or cardiovascular mortality after HTx.

【 授权许可】

CC BY|CC BY-NC-ND