Cambridge-Miami Score for Intestinal Transplantation Preoperative Risk Assessment: Initial Development and Validation

Middleton, Stephen; Nishida, Seigo; Tzakis, Andreas G.; Woodward, J; Duncan, Samantha; Watson, Chris; Wiles, A; Sivaprakasam, Rajesh; Butler, Andrew; Gabe, Simon; Jamieson, Neville V.

doi:10.1016/j.transproceed.2009.12.022

Cited by 16 publications

(4 citation statements)

References 7 publications

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“…It should be noted that perfect prediction tools do not exist. However, a number of prediction tools from different clinical settings showed accuracy greater than 80% [16][17][18]. In consequence, it could be stated that our novel predictors are still suboptimal or that the endpoints are harder to predict.…”

Section: Discussionmentioning

confidence: 93%

Prediction of Complications in Radical Prostatectomy Prostate Cancer Patients: Simulated Annealing versus Co-Morbidity Indexes

et al. 2018

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Background: The Deyo/Charlson co-morbidity index (CCI) and Klabunde co-morbidity index (KCI) co-morbidity indexes represent outdated indexes when the endpoint of complications after radical prostatectomy (RP) is considered. A novel group of co-morbidities derived from International Classification of Diseases-9 diagnostic codes in a contemporary RP database could provide better accuracy. Research Design, Subjects and Measures: We relied on 20,484 patients with clinically localized non-metastatic prostate cancer treated with RP between 2000 and 2009 in the Surveillance, Epidemiology, and End Results-Medicare linked database. We examined 2 endpoints, namely, 90-day medical complication rate and 90-day surgical complication rate after RP. Simulated annealing (SA) was used to develop a novel co-morbidity index. Finally, the newly identified groups of co-morbid conditions were compared with the CCI and Klabunde indexes. Results: Our SA identified 10 and 7 individual co-morbid conditions able to predict 90-day medical and surgical complications respectively. This novel model showed improved predictive accuracy over CCI and KCI for the 2 endpoints considered (respectively: 59.4 vs. 58.1 and 58.0% for medical complications, 58.0 vs. 56.8 and 56.7% for surgical complications). Conclusions: The newly defined groupings of co-morbid conditions resulted in better ability to predict the 2 endpoints of interest compared to CCI and KCI. However, the gain was marginal. This implies that better tools should be defined to more accurately predict these outcomes.

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Section: Discussionmentioning

confidence: 93%

Prediction of Complications in Radical Prostatectomy Prostate Cancer Patients: Simulated Annealing versus Co-Morbidity Indexes

et al. 2018

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“…Stratification of patients according to projected post‐transplant survival requires the development of a preoperative risk assessment score. The Cambridge–Miami score, based on comorbidities and venous access, has been reported in a small series of 20 patients, and awaits further validation 23 …”

Section: Intestinal Transplantation: Indications and Timing Of Referralmentioning

confidence: 99%

Intestinal transplantation: Current status and future directions

Garg

Jones

Vaughan

et al. 2011

J of Gastro and Hepatol

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Three decades after the first intestinal transplant was performed in humans, this life-saving procedure has come of age and now offers hope of long-term survival in a small group of patients with life-threatening complications of intestinal failure and parenteral nutrition. Success rates have greatly improved, largely through advances in immunosuppression protocols, improved surgical technique and postoperative care, and accumulated experience. Management of the intestinal transplant recipient entails careful surveillance, prevention, and treatment of rejection and infection, as well as optimization of feeding and nutrition. With this approach, survival and quality of life are demonstrably improved, such that intestinal transplantation is now an established and accepted procedure for this very select group of highly-complex patients.

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“…The preoperative status of patients has been found to influence the outcome of surgery [1], and scores developed to semiquantify this [2, 3] have been used in routine practice to facilitate preoperative risk assessment. There has been considerable improvement in postoperative survival over the last 20 years.…”

Section: Introductionmentioning

confidence: 99%

“…It has therefore become very important to accurately assess patient's individual survival chance. In our routine clinical practice, we have considered preoperative comorbidity to have a negative influence on postoperative survival [3]. We have semiquantified comorbidity for each patient and compared this to postoperative survival to determine the relationship.…”

Section: Introductionmentioning

confidence: 99%

Preoperative Comorbidity Correlates Inversely with Survival after Intestinal and Multivisceral Transplantation in Adults

Sivaprakasam

Takahashi

Pither

et al. 2013

Journal of Transplantation

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We investigated the relationship between preoperative comorbidity and postoperative survival after intestinal transplantation. Each patient received a score for preoperative comorbidity. Each comorbidity was given a score based on the degree it impaired function (score range 0–3). A total score was derived from the summation of individual comorbidity scores. Patients (72 adults (M : F, 33 : 39)) received an isolated intestinal graft (27) or a cluster graft (45). Mean (standard deviation) survival was 1501 (1444) days. The Kaplan-Meier analysis revealed a significant inverse association between survival and comorbidity score (logrank test for trend, P < 0.0001). Patients grouped into comorbidity scores of 0 and 1, 2 and 3, 4 and 5, 6, and above had hazard ratios (95% confidence intervals) for death (compared to group 0 + 1), which increased with comorbidity scores: 1.945 (0.7622–5.816), 5.075 (3.314–36.17), and 13.77 (463.3–120100), respectively, (P < 0.0001). Receiver-operator curves at 1, 3, 5, and 10 years postoperative had “C” statistics of 0.88, 0.85, 0.88, and 0.92, respectively. When evaluating patients for transplantation, the degree of comorbidity should be considered as a major factor influencing postoperative survival.

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Cambridge-Miami Score for Intestinal Transplantation Preoperative Risk Assessment: Initial Development and Validation

Cited by 16 publications

References 7 publications

Prediction of Complications in Radical Prostatectomy Prostate Cancer Patients: Simulated Annealing versus Co-Morbidity Indexes

Prediction of Complications in Radical Prostatectomy Prostate Cancer Patients: Simulated Annealing versus Co-Morbidity Indexes

Intestinal transplantation: Current status and future directions

Preoperative Comorbidity Correlates Inversely with Survival after Intestinal and Multivisceral Transplantation in Adults

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