Adult CF Unit, Liverpool Heart and Chest Hospital NHS Trust, Liverpool, UK.
Liverpool Heart and Chest Hospital NHS Trust, Liverpool, UK.
Transpl Int. 2021 Mar;34(3):436-444. doi: 10.1111/tri.13805. Epub 2021 Jan 24.
Models that predict outcomes, aid prognostication and inform the assessment of urgency for lung transplantation (LT) in CF are in demand. A prognostic score derived from the French adult CF registry to predict death or LT over 3-year follow-up was described in 2017 and validated using Canadian CF registry data. We assessed its performance in the UK CF population. The French prognostic score was applied to untransplanted adults with CF. The index year (2014) and outcomes (Death or LT) were evaluated to 2017. Receiver operator characteristics plots and area under curve (AUC) was computed. 4407 adults with CF met the inclusion criteria. After 3 years, 7.1% (P < 0.001) were dead or had received LT compared to the French (12.8%) and Canadian (9.4%) cohorts. The French score deemed 592 (26.2%) 'High-risk' - death/LT occurred in 189/592 (30.2%), less than previously reported in France and Canada (P < 0.0001). The discriminatory power of the French score was lower (AUC 0.830) than reported. Recalibration yielded only marginal improvement in model performance (AUC 0.833). The French prognostic score does not perform as well in the UK as reported elsewhere. Bespoke UK scores are needed to aid prognostication and inform LT decision-making.
预测结局、辅助预后判断并为肺移植（LT）的紧迫性评估提供信息的模型在 CF 中需求量很大。2017 年描述了一种源自法国成人 CF 登记处的预后评分，用于预测 3 年随访期间的死亡或 LT，并使用加拿大 CF 登记处的数据进行了验证。我们评估了其在英国 CF 人群中的表现。该法国预后评分应用于未接受移植的 CF 成年患者。评估了索引年（2014 年）和结局（死亡或 LT）至 2017 年。计算了接收者操作特征图和曲线下面积（AUC）。4407 名 CF 成年患者符合纳入标准。3 年后，7.1%（P<0.001）死亡或接受 LT，而法国（12.8%）和加拿大（9.4%）队列的这一比例分别为 7.1%和 9.4%。法国评分认为 592 名（26.2%）患者为“高危”-592 名中有 189 名（30.2%）发生死亡/LT，这一比例低于法国和加拿大的先前报告（P<0.0001）。法国评分的判别能力较低（AUC 0.830）。重新校准仅略微改善了模型性能（AUC 0.833）。法国预后评分在英国的表现不如其他地方报道的那样好。需要定制英国评分来辅助预后判断并为 LT 决策提供信息。
