Screening scale predicts patients successfully receiving long-term implantable left ventricular assist devices

M. C. Oz, Daniel J. Goldstein, P. Pepino, A. D. Weinberg, S. M. Thompson, K. A. Catanese, R. L. Vargo, P. M. McCarthy, E. A. Rose, H. R. Levin

Research output: Contribution to journalArticle

152 Citations (Scopus)

Abstract

Background: Although use of long-term implantable left ventricular assist devices (LVAD) is becoming more popular, further reduction of the mortality rate accompanying device insertion through improved patient selection would make this alternative even more appealing. We sought to develop a scoring system that was based on criteria obtainable at the time of evaluation and predictive of successful early outcome and simple to apply. Methods and Results: Patients (n=56) undergoing LVAD insertion between 1990 and 1994 were screened for easily obtainable preoperative risk factors. To test the association between survival and each risk factor, a χ2 analysis was performed, and relative risks were estimated. Oliguria, ventilator dependence, elevated central venous pressure, elevated prothrombin time, and reoperation status had low probability values and high estimated relative risks. On the basis of these relations, a risk factor-selection scale (RFSS) (range, 0 to 10) was developed by computing appropriate weights for each risk factor. The distribution of patients for each scale score reveal that with RFSS ≥5, most device recipients will die (P<.001). The average RFSS (±SD) of survivors (n =42) was 2.45±1.73 compared with 5.43±2.85 in nonsurvivors (n=14) (P<.0001). Univariate logistical regzression was also significant (score statistic, 16.2; df=1; P=001). Conclusions: The RFSS is simple, easy to apply, and statistically valid. Physicians could use the scale as a starting point in discussing the suitability for LVAD implantation in a specific patient and as a basis for comparing patient outcomes.

Original languageEnglish (US)
JournalCirculation
Volume92
Issue number9 SUPPL.
StatePublished - 1995
Externally publishedYes

Fingerprint

Heart-Assist Devices
Oliguria
Equipment and Supplies
Central Venous Pressure
Prothrombin Time
Mechanical Ventilators
Reoperation
Patient Selection
Survivors
Physicians
Weights and Measures
Survival
Mortality

Keywords

  • heart failure
  • heart-assist device
  • mortality
  • risk factors

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

Oz, M. C., Goldstein, D. J., Pepino, P., Weinberg, A. D., Thompson, S. M., Catanese, K. A., ... Levin, H. R. (1995). Screening scale predicts patients successfully receiving long-term implantable left ventricular assist devices. Circulation, 92(9 SUPPL.).

Screening scale predicts patients successfully receiving long-term implantable left ventricular assist devices. / Oz, M. C.; Goldstein, Daniel J.; Pepino, P.; Weinberg, A. D.; Thompson, S. M.; Catanese, K. A.; Vargo, R. L.; McCarthy, P. M.; Rose, E. A.; Levin, H. R.

In: Circulation, Vol. 92, No. 9 SUPPL., 1995.

Research output: Contribution to journalArticle

Oz, MC, Goldstein, DJ, Pepino, P, Weinberg, AD, Thompson, SM, Catanese, KA, Vargo, RL, McCarthy, PM, Rose, EA & Levin, HR 1995, 'Screening scale predicts patients successfully receiving long-term implantable left ventricular assist devices', Circulation, vol. 92, no. 9 SUPPL..
Oz, M. C. ; Goldstein, Daniel J. ; Pepino, P. ; Weinberg, A. D. ; Thompson, S. M. ; Catanese, K. A. ; Vargo, R. L. ; McCarthy, P. M. ; Rose, E. A. ; Levin, H. R. / Screening scale predicts patients successfully receiving long-term implantable left ventricular assist devices. In: Circulation. 1995 ; Vol. 92, No. 9 SUPPL.
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AU - Oz, M. C.

AU - Goldstein, Daniel J.

AU - Pepino, P.

AU - Weinberg, A. D.

AU - Thompson, S. M.

AU - Catanese, K. A.

AU - Vargo, R. L.

AU - McCarthy, P. M.

AU - Rose, E. A.

AU - Levin, H. R.

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N2 - Background: Although use of long-term implantable left ventricular assist devices (LVAD) is becoming more popular, further reduction of the mortality rate accompanying device insertion through improved patient selection would make this alternative even more appealing. We sought to develop a scoring system that was based on criteria obtainable at the time of evaluation and predictive of successful early outcome and simple to apply. Methods and Results: Patients (n=56) undergoing LVAD insertion between 1990 and 1994 were screened for easily obtainable preoperative risk factors. To test the association between survival and each risk factor, a χ2 analysis was performed, and relative risks were estimated. Oliguria, ventilator dependence, elevated central venous pressure, elevated prothrombin time, and reoperation status had low probability values and high estimated relative risks. On the basis of these relations, a risk factor-selection scale (RFSS) (range, 0 to 10) was developed by computing appropriate weights for each risk factor. The distribution of patients for each scale score reveal that with RFSS ≥5, most device recipients will die (P<.001). The average RFSS (±SD) of survivors (n =42) was 2.45±1.73 compared with 5.43±2.85 in nonsurvivors (n=14) (P<.0001). Univariate logistical regzression was also significant (score statistic, 16.2; df=1; P=001). Conclusions: The RFSS is simple, easy to apply, and statistically valid. Physicians could use the scale as a starting point in discussing the suitability for LVAD implantation in a specific patient and as a basis for comparing patient outcomes.

AB - Background: Although use of long-term implantable left ventricular assist devices (LVAD) is becoming more popular, further reduction of the mortality rate accompanying device insertion through improved patient selection would make this alternative even more appealing. We sought to develop a scoring system that was based on criteria obtainable at the time of evaluation and predictive of successful early outcome and simple to apply. Methods and Results: Patients (n=56) undergoing LVAD insertion between 1990 and 1994 were screened for easily obtainable preoperative risk factors. To test the association between survival and each risk factor, a χ2 analysis was performed, and relative risks were estimated. Oliguria, ventilator dependence, elevated central venous pressure, elevated prothrombin time, and reoperation status had low probability values and high estimated relative risks. On the basis of these relations, a risk factor-selection scale (RFSS) (range, 0 to 10) was developed by computing appropriate weights for each risk factor. The distribution of patients for each scale score reveal that with RFSS ≥5, most device recipients will die (P<.001). The average RFSS (±SD) of survivors (n =42) was 2.45±1.73 compared with 5.43±2.85 in nonsurvivors (n=14) (P<.0001). Univariate logistical regzression was also significant (score statistic, 16.2; df=1; P=001). Conclusions: The RFSS is simple, easy to apply, and statistically valid. Physicians could use the scale as a starting point in discussing the suitability for LVAD implantation in a specific patient and as a basis for comparing patient outcomes.

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