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Pre-Transplant Cardiovascular Risk Factors Improve the SRTR Cox Proportional Hazard Model for 1 Year Patient Survival after Deceased Donor Kidney Transplant

R. Pelletier, A. Rajab, T. Pesavento, M. Henry

Surgery/Transplantation, The Ohio State University Wexner Medical Center, Columbus, OH

Meeting: 2013 American Transplant Congress

Abstract number: 333

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Background:Debate continues regarding the utility of including additional clinical variables to improve SRTR center-specific predicted outcomes. In this study we used a cohort of kidney recipients transplanted in our program. [bold}Results: There were 586 deceased adult kidney transplant procedures performed at our center between 1/1/2002 and 6/30/2008. All covariates included in the Cox proportional hazards model for 1 year patient suvival reported by SRTR on 1/13/2012 were included in our initial Cox model (SRTR Model). We then performed Cox models with each of 12 additional covariates and finally with all 12 additional covariates. Each Cox model predicted 1 year patient survival and number of graft losses, and Log likelihood are reported in the table below. Also, the Likelihood ratio test (tests whether the Log likelihood is significantly different than that for the SRTR Model), Harrell’s C discrimination, and the Goodness of fit test were performed for each Cox model and reported in the table below.

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To cite this abstract in AMA style:

Pelletier R, Rajab A, Pesavento T, Henry M. Pre-Transplant Cardiovascular Risk Factors Improve the SRTR Cox Proportional Hazard Model for 1 Year Patient Survival after Deceased Donor Kidney Transplant [abstract]. Am J Transplant. 2013; 13 (suppl 5). https://atcmeetingabstracts.com/abstract/pre-transplant-cardiovascular-risk-factors-improve-the-srtr-cox-proportional-hazard-model-for-1-year-patient-survival-after-deceased-donor-kidney-transplant/. Accessed April 21, 2021.

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        Model 1 Year Survival # of Graft Losses at 1 Year Log-Likelihood Likelihood Ratio Test, P-Value Harrell's C (discrimination) Goodness of Fit P-Value
        Observed 90.4 56.0        
        SRTR Model, Only 90.2 62.0 -317.6 — 0.603 0.055
        Limb Amputation 90.3 61.4 -317.5 0.702 0.605 0.055
        Lower Extremity Bypass 89.9 64.0 -317.3 0.472 0.604 0.019
        Aortic Surgery 90.2 62.0 -317.6 0.991 0.603 0.055
        Pre-Tx LVEF and Indicator Variable for Missing 91.2 56.4 -312.4 0.006 0.639 0.080
        Coronary Artery Revascularization 89.7 65.3 -317.2 0.400 0.603 0.041
        Pre-Transplant MI 89.3 68.6 -315.6 0.050 0.601 0.172
        Smoking History 87.7 79.5 -316.3 0.118 0.619 0.025
        Diabetes – Type 2 91.2 55.2 -316.8 0.218 0.613 0.023
        Diabetes – Type 1 90.2 62.0 -317.6 0.999 0.603 0.054
        Employed Full or Part-Time 90.6 59.2 -317.4 0.591 0.609 0.036
        Ambulatory 93.0 43.3 -316.8 0.231 0.607 0.016