Key result
The MELD-XI scoring system had better prognostic utility for one-year mortality than the HFSS scale (AUC 0.812 vs 0.781), while the MAGGIC scale was comparable to HFSS (AUC 0.771).
Why the study?
Do the MELD-XI and MAGGIC scales improve prognostic prediction of one-year mortality compared to the HFSS scale in ambulatory patients with end-stage heart failure awaiting heart transplantation?
Observational (n=370)
No
Do the MELD-XI and MAGGIC scales improve prognostic prediction of one-year mortality compared to the HFSS scale in ambulatory patients with end-stage heart failure awaiting heart transplantation?
The MELD-XI scoring system provides superior prognostic utility compared to the HFSS scale for predicting one-year mortality in ambulatory patients with end-stage heart failure awaiting heart transplantation.
BACKGROUND: Due to the increasing number of patients placed on waiting lists for orthotopic heart transplantation (OHT), the selection of patients with the highest risk of death has become paramount. AIM: This study aimed to evaluate the predictive value of the Model for End-stage Liver Disease eXcluding INR (MELD-XI) and Meta-Analysis Global Group in Chronic Heart Failure (MAGGIC) scales in ambulatory patients awaiting OHT and compare them to the Heart Failure Survival Score (HFSS). METHODS: The study was a retrospective review of 370 adult ambulatory patients with end-stage heart failure, who were added to the OHT waiting list at our institution between 2012 and 2016. RESULTS: The median age of the patients was 54.0 (46.0-60.0) years, and 324 (87.6%) of them were male. The overall one-year mortality was 27.6%. The areas under the curve (AUCs) for the MAGGIC and HFSS scales were comparable: 0.771 (95% confidence interval [CI] 0.720-0.823); sensitivity 77%, specificity 68% vs. 0.781 (95% CI 0.732-0.829); sensitivity 90%, specificity 58%, respectively. The AUC for the MELD-XI scale was higher than that for the HFSS scale: 0.812 (95% CI 0.769-0.856); sensitivity 91%, specificity 63% vs. 0.781 (95% CI 0.732-0.829) sensitivity 90%, specificity 58%, respectively. CONCLUSIONS: Our study demonstrated that elevated MELD-XI and MAGGIC scores and lowered HFSS scores were associated with an increased risk of death during one-year follow-up. The prognostic utility of the MELD-XI scoring system was better than that of the HFSS scale, while the MAGGIC scale was comparable to the HFSS.
No takes yet. Share an insight, caveat, or question.
Szczurek et al. (2018) conducted an observational in End-stage heart failure (n=370). MELD-XI and MAGGIC scales vs. HFSS scale was evaluated on One-year mortality (AUC 0.812, 95% CI 0.769-0.856). The MELD-XI scoring system had better prognostic utility for one-year mortality than the HFSS scale (AUC 0.812 vs 0.781), while the MAGGIC scale was comparable to HFSS (AUC 0.771).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: