Development and Validation of the LIFE-5S Score for Predicting 5-Year Mortality After Transvenous Lead Extraction

Area of Science:

• Cardiology
• Medical Devices
• Prognostics

Background:

• Long-term mortality after transvenous lead extraction (TLE) is significant, yet simple prognostic tools are lacking.
• Existing methods do not adequately stratify risk for patients undergoing TLE.

Purpose of the Study:

• To develop and validate a simple, bedside tool for estimating long-term mortality risk after successful TLE.
• To identify independent predictors of 5-year mortality following TLE.

Main Methods:

• Retrospective analysis of 3368 patients undergoing TLE (2006-2020) with 5-year follow-up.
• Development of the LIFE-5S risk score using multivariable Cox analysis.
• Validation in a separate cohort (n=1684).

Main Results:

• Cumulative 5-year mortality was 32.2%.
• Key predictors included male sex, age, atrial fibrillation, heart failure, diabetes, renal dysfunction, reduced ejection fraction, pocket infection, endocarditis, and CRT.
• The LIFE-5S score showed good discrimination (AUC ~0.78) and calibration.

Conclusions:

• The LIFE-5S score is a validated tool for bedside prognostic stratification after TLE.
• This score can aid clinical decision-making, patient counseling, and personalized follow-up strategies.
• An online calculator is available for clinical application.