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Impacts can be classified in various forms, primarily under two subgroups: central impact and oblique impact. A central impact occurs when two objects collide head-on, possessing opposite velocities aligned along the line of impact. Conversely, an oblique impact occurs when two objects collide at an angle, resulting in a modification of both direction and velocity.
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Updated: Jun 18, 2025

Use of Galvanic Skin Responses, Salivary Biomarkers, and Self-reports to Assess Undergraduate Student Performance During a Laboratory Exam Activity
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The IMPACT Score: Does Sex Matter?

Mandisa-Maia Jones1, Virginia Tangel2, Robert S White3

  • 1Department of Anesthesiology, Division of Cardiothoracic Anesthesia, New York Presbyterian Weill Cornell Medical Center, New York, NY.

Journal of Cardiothoracic and Vascular Anesthesia
|July 28, 2024
PubMed
Summary

The IMPACT score has poor accuracy for predicting 1-year mortality risk after heart transplantation in both women and men. No significant sex-based differences in mortality were observed in this study.

Keywords:
heart failureheart transplantationsex

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Area of Science:

  • Cardiology
  • Transplantation Medicine
  • Biostatistics

Background:

  • The Index for Mortality Prediction After Cardiac Transplantation (IMPACT) score is a validated tool for predicting 1-year mortality risk post-orthotopic heart transplantation (OHT).
  • The IMPACT score was developed using data where women were underrepresented, raising questions about its generalizability.
  • The performance of the IMPACT score specifically in predicting mortality risk in female heart transplant recipients remains unexamined.

Purpose of the Study:

  • To evaluate the accuracy of the IMPACT score in predicting 1-year mortality after OHT in women.
  • To compare the performance of the IMPACT score between sexes.
  • To test the hypothesis that the IMPACT score is an inadequate predictor of 1-year mortality in women post-OHT.

Main Methods:

  • An external validation study utilizing data from the International Society for Heart and Lung Transplantation registry (2009-2018).
  • Inclusion criteria: first-time, single OHT recipients aged 18 years and older.
  • Statistical analysis involved comparing demographic and clinical characteristics by sex, calculating the IMPACT score, and assessing model discrimination (area under the receiver operating characteristic curve) and calibration.

Main Results:

  • The IMPACT score demonstrated poor discrimination for 1-year mortality, with an area under the receiver operating characteristic curve of 0.59 overall (0.58 for women, 0.59 for men).
  • Calibration analysis also indicated poor model fit.
  • The 1-year mortality rate was 9.4% in the overall cohort, with no statistically significant difference between women (9.0%) and men (9.6%).

Conclusions:

  • The IMPACT score shows poor discrimination and calibration for predicting 1-year mortality in a contemporary cohort of OHT recipients.
  • The study's findings suggest the IMPACT score is not a reliable predictor of mortality in this population, irrespective of sex.
  • There is no evidence of sex-based disparities in 1-year mortality after OHT within this cohort.