Composite risk scores and depression as predictors of competing waiting‐list outcomes: the Waiting for a New Heart Study
Composite risk scores and depression as predictors of competing waiting‐list outcomes: the Waiting for a New Heart Study
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综合风险评分和抑郁症作为竞争等待名单结果的预测因子：等待新心脏研究
DOI：
10.1111/j.1432-2277.2010.01133.x
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发表时间：
2010
影响因子：
3.1
通讯作者：
Spaderna
中科院分区：
文献类型：
--
作者：
Weidner;Beyersmann;Kaczmarek;Mehlhorn;Reichenspurner;Wagner;Spaderna
我们评估了两个复合风险评分（心力衰竭生存评分，HFSS;德国移植学会评分，GTSS）和抑郁作为死亡率和竞争性等待名单结局[高度紧急移植（HU‐HTx），选择性移植，因临床改善而除名]的预测因子，来自17家医院的318名心脏移植（HTx）候选人（18%女性;年龄53 ± 11岁），并在Eurotransplant新注册。 采用问卷调查法对人口统计学变量和抑郁（医院焦虑抑郁量表，HADS）进行评估。计算HFSS和GTSS的变量、年龄、药物和结局由Eurotransplant提供。12个月时，33例患者死亡，83例接受紧急HTx，30例选择性HTx，17例因改善而被除名。 应用病因特异性考克斯回归分析，仅HFSS与1年死亡率显著相关[HR = 0.64（95% CI = 0.43-0.95），P= 0.029]。 GTSS是HU‐HTx的最强预测因子[HR = 1.02（95% CI = 1.01-1.02），P<0.001]。 即使在调整年龄和风险评分后，低抑郁评分也显著有助于临床改善[HADS：HR = 0.12（95% CI = 0.02-0.89），P= 0.039]。 这些结果证实了复合风险评分对预测死亡率和HU‐HTx的有用性，验证了两种评分的预期用途。抑郁症是等待名单结果临床改善的独立预测因素，这一发现表明，除了考虑患者的医疗特征外，还应考虑患者的心理属性。
We evaluated two composite risk scores, (Heart Failure Survival Score, HFSS; German Transplant Society Score, GTSS), and depression as predictors of mortality and competing waiting‐list outcomes [high‐urgency transplantation (HU‐HTx), elective transplantation, delisting because of clinical improvement] in 318 heart transplant (HTx) candidates (18% women; aged 53 ± 11 years) from 17 hospitals and newly registered with Eurotransplant. Demographic variables and depression (Hospital Anxiety and Depression Scale, HADS) were assessed using questionnaires. Variables to compute HFSS and GTSS, age, medications, and outcomes were provided by Eurotransplant. At 12 months, 33 patients died, 83 received urgent HTx, 30 elective HTx, and 17 were delisted because of improvement. Applying cause‐specific Cox regressions, only the HFSS was significantly associated with 1‐year mortality [HR = 0.64 (95% CI = 0.43–0.95),P= 0.029]. The GTSS was the strongest predictor of HU‐HTx [HR = 1.02 (95% CI = 1.01–1.02),P< 0.001]. Low depression scores contributed significantly to clinical improvement, even after adjusting for age and risk scores [HADS: HR = 0.12 (95% CI = 0.02–0.89),P= 0.039]. These findings confirm the usefulness of composite risk scores for the prediction of mortality and HU‐HTx, validating both scores for their intended use. The finding that depression was an independent predictor of the waiting‐list outcome clinical improvement suggests that considering patients’ psychological attributes in addition to their medical characteristics is advisable.
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影响因子：
2
作者：
Beyersmann, Jan;Dettenkofer, Markus;Schumacher, Martin
通讯作者：
Schumacher, Martin
心脏移植候选人的心理社会和行为因素——概述
影响因子：
3.1
作者：
H. Spaderna;J. Smits;A. Rahmel;G. Weidner
通讯作者：
G. Weidner
影响因子：
6.2
作者：
Smits, JMA;Deng, MC;van Houwelingen, HC
通讯作者：
van Houwelingen, HC
影响因子：
--
作者：
Deng, MC;De Meester, JMJ;Scheld, HH
通讯作者：
Scheld, HH
影响因子：
2.8
作者：
Lund, LH;Aaronson, KD;Mancini, DM
通讯作者：
Mancini, DM