Evaluation of a Flexible Weight and Height Interaction Versus Body Mass Index for Mortality Prediction After Adult Heart Transplant
Experimental and Clinical Transplantation, ISSN: 1304-0855, Vol: 20, Issue: 9, Page: 849-853
2022
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Findings from University of Connecticut Provides New Data about Heart Transplants (Evaluation of a Flexible Weight and Height Interaction Versus Body Mass Index for Mortality Prediction After Adult Heart Transplant)
2022 NOV 09 (NewsRx) -- By a News Reporter-Staff News Editor at NewsRx Cardiovascular Daily -- Investigators discuss new findings in Transplant Medicine - Heart
Article Description
Objectives: Body mass index (calculated as kilograms body weight divided by the square of height in meters) is a known predictor of mortality after adult heart transplant but has limitations. We investigated whether inclusion of an explicit weight-height interaction effect improves prediction of mortality after heart transplant compared with body mass index. Methods and Results: We included a cohort of 46 424 adults who had undergone heart transplant as documented in the United Network for Organ Sharing database. Risk-adjusted prediction models for 1-year and 5-year mortality were constructed, one with the flexible weight-height interaction and the other with the body mass index. Overall model performance (R) and discrimination (the Harrell concordance probability C index and the Somers D rank correlation) were calculated. Compared with the body mass index model, the weight-height model had slightly improved overall performance (R, 0.316 vs 0.313) and 1-year mortality discrimination (optimism-corrected Harrell C, 0.642 vs 0.640; Somers D, 0.284 vs 0.281). Compared with the body mass index model, the weight-height model had improved overall performance (R, 0.232 vs 0.224) and similar discrimination (optimism-corrected Harrell C, 0.600 vs 0.599; Somers D, 0.200 vs 0.197) for 5-year mortality. Conclusions: Allowance for a flexible relationship between height and weight did not appreciably improve mortality prediction after heart transplant, versus body mass index, although additional research is warranted.
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Baskent University
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