External Validation of the DCD-N Score and a Linear Prediction Model to Identify Potential Candidates for Organ Donation After Circulatory Death : A Nationwide Multicenter Cohort Study
Copyright © 2020 The Author(s). Published by Wolters Kluwer Health, Inc..
BACKGROUND: Donation after circulatory death (DCD) is a procedure in which after planned withdrawal of life-sustaining treatment (WLST), the dying process is monitored. A DCD procedure can only be continued if the potential organ donor dies shortly after WLST. This study performed an external validation of 2 existing prediction models to identify potentially DCD candidates, using one of the largest cohorts.
METHODS: This multicenter retrospective study analyzed all patients eligible for DCD donation from 2010 to 2015. The first model (DCD-N score) assigned points for absence of neurological reflexes and oxygenation index. The second model, a linear prediction model (LPDCD), yielded the probability of death within 60 min. This study determined discrimination (c-statistic) and calibration (Hosmer and Lemeshow test) for both models.
RESULTS: This study included 394 patients, 283 (72%) died within 60 min after WLST. The DCD-N score had a c-statistic of 0.77 (95% confidence intervals, 0.71-0.83) and the LPDCD model 0.75 (95% confidence intervals, 0.68-0.81). Calibration of the LPDCD 60-min model proved to be poor (Hosmer and Lemeshow test, P < 0.001).
CONCLUSIONS: The DCD-N score and the LPDCD model showed good discrimination but poor calibration for predicting the probability of death within 60 min. Construction of a new prediction model on a large data set is needed to obtain better calibration.
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CommentIn: Transplantation. 2021 Jun 1;105(6):1165-1166. - PMID 32858574 |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:105 |
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| Enthalten in: |
Transplantation - 105(2021), 6 vom: 01. Juni, Seite 1311-1316 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Nijhoff, Maaike F [VerfasserIn] |
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| Links: |
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Journal Article |
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| Anmerkungen: |
Date Completed 26.07.2021 Date Revised 02.10.2023 published: Print CommentIn: Transplantation. 2021 Jun 1;105(6):1165-1166. - PMID 32858574 Citation Status MEDLINE |
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| doi: |
10.1097/TP.0000000000003430 |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM314317724 |
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| 245 | 1 | 0 | |a External Validation of the DCD-N Score and a Linear Prediction Model to Identify Potential Candidates for Organ Donation After Circulatory Death |b A Nationwide Multicenter Cohort Study |
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| 500 | |a Date Revised 02.10.2023 | ||
| 500 | |a published: Print | ||
| 500 | |a CommentIn: Transplantation. 2021 Jun 1;105(6):1165-1166. - PMID 32858574 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2020 The Author(s). Published by Wolters Kluwer Health, Inc. | ||
| 520 | |a BACKGROUND: Donation after circulatory death (DCD) is a procedure in which after planned withdrawal of life-sustaining treatment (WLST), the dying process is monitored. A DCD procedure can only be continued if the potential organ donor dies shortly after WLST. This study performed an external validation of 2 existing prediction models to identify potentially DCD candidates, using one of the largest cohorts | ||
| 520 | |a METHODS: This multicenter retrospective study analyzed all patients eligible for DCD donation from 2010 to 2015. The first model (DCD-N score) assigned points for absence of neurological reflexes and oxygenation index. The second model, a linear prediction model (LPDCD), yielded the probability of death within 60 min. This study determined discrimination (c-statistic) and calibration (Hosmer and Lemeshow test) for both models | ||
| 520 | |a RESULTS: This study included 394 patients, 283 (72%) died within 60 min after WLST. The DCD-N score had a c-statistic of 0.77 (95% confidence intervals, 0.71-0.83) and the LPDCD model 0.75 (95% confidence intervals, 0.68-0.81). Calibration of the LPDCD 60-min model proved to be poor (Hosmer and Lemeshow test, P < 0.001) | ||
| 520 | |a CONCLUSIONS: The DCD-N score and the LPDCD model showed good discrimination but poor calibration for predicting the probability of death within 60 min. Construction of a new prediction model on a large data set is needed to obtain better calibration | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Multicenter Study | |
| 650 | 4 | |a Observational Study | |
| 650 | 4 | |a Validation Study | |
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| 700 | 1 | |a Volbeda, Meint |e verfasserin |4 aut | |
| 700 | 1 | |a Kotsopoulos, Angela M M |e verfasserin |4 aut | |
| 700 | 1 | |a Sonneveld, Johan P C |e verfasserin |4 aut | |
| 700 | 1 | |a Otterspoor, Luuk |e verfasserin |4 aut | |
| 700 | 1 | |a Abdo, Wilson F |e verfasserin |4 aut | |
| 700 | 1 | |a Silderhuis, Vera M |e verfasserin |4 aut | |
| 700 | 1 | |a El Moumni, Mostafa |e verfasserin |4 aut | |
| 700 | 1 | |a Moers, Cyril |e verfasserin |4 aut | |
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