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Screening scale predicts patients successfully receiving long-term implantable left ventricular assist devices
M C Oz1, D J Goldstein, P Pepino
1Department of Surgery, College of Physicians and Surgeons, Columbia University, New York, NY, USA.
Circulation
|November 1, 1995
Summary
A new Risk Factor-Selection Scale (RFSS) helps predict outcomes for patients receiving a left ventricular assist device (LVAD). Higher scores indicate increased risk, aiding in better patient selection for LVAD implantation.
Area of Science:
- Cardiology
- Medical Devices
- Surgical Outcomes
Background:
- Long-term implantable left ventricular assist devices (LVAD) are increasingly used.
- Improved patient selection is crucial to reduce mortality associated with LVAD insertion.
- A need exists for a simple, predictive scoring system for early LVAD outcomes.
Purpose of the Study:
- To develop a scoring system for predicting successful early outcomes in LVAD recipients.
- The system should utilize criteria available at the time of patient evaluation.
- The scale should be simple and easy to apply in clinical practice.
Main Methods:
- Screened 56 patients undergoing LVAD insertion (1990-1994) for preoperative risk factors.
- Utilized chi-squared analysis and relative risk estimation to assess factor-survival association.
- Developed the Risk Factor-Selection Scale (RFSS) based on significant risk factors: oliguria, ventilator dependence, elevated central venous pressure, elevated prothrombin time, and reoperation.
Main Results:
- The RFSS ranges from 0 to 10.
- Patients with an RFSS of 5 or greater had significantly higher mortality (P < .001).
- Average RFSS was 2.45 in survivors versus 5.43 in non-survivors (P < .0001).
Conclusions:
- The developed Risk Factor-Selection Scale (RFSS) is statistically valid and simple to implement.
- Physicians can use the RFSS to guide discussions on LVAD suitability.
- The scale provides a basis for comparing patient outcomes after LVAD implantation.