(1108). Implementing the Index for Mortality Prediction After Cardiac. Transplantation Risk Scores to Optimize Resources. E.I. Jeng ,1 P. Lipori,2 D.J. Hall,1 L.
Abstracts S429 smoking. Survival analysis was conducted (KM & log-ranks). Postoperative complications and mortality were assessed using multivariable logistic regression and Cox proportional hazard modeling. Results: Review of 24,909 HTx reveled 11,709 (47%) rSmkH. Baseline recipient and donor characteristics were different for rSmkH and the never smoker recepients (Tables 1-2). Smokers had significantly worse graft survival with an adjusted hazard ratio of 1.16 (95% CI 1.10-1.22) (Figure 1). Smoking was significantly associated with death due to malignancy (OR
1.75, 95% CI 1.45-2.13), but was not independently associated with graft failure due to rejection or infection. Conclusion: Recipient smoking history is a significant risk factor for death following cardiac transplantation, largely due to increased risk for malignancy. 1( 108) Implementing the Index for Mortality Prediction After Cardiac Transplantation Risk Scores to Optimize Resources E.I. Jeng ,1 P. Lipori,2 D.J. Hall,1 L. Duce,3 M.M. Ahmed,4 J. Vilaro,4 J.M. Aranda,4 T.M. Beaver,1 G.J. Arnaoutakis.1 1Surgery, University of Florida, Gainesville, FL; 2Finance, University of Florida, Gainesville, FL; 3Anesthesiology, University of Florida, Gainesville, FL; 4Medicine, University of Florida, Gainesville, FL. Purpose: The Index for Mortality Prediction after Cardiac Transplantation (IMPACT) risk score incorporates 12 pre-operative recipient specific variables, and has been validated as an accurate predictor of short- and long-term mortality after orthotopic heart transplantation (OHTx). We believe it can also be used to predict cost, and hypothesize that higher preoperative IMPACT risk scores are associated with increased hospital resource consumption. Methods: All OHTx patients ≥ 18 years of age at our institution were reviewed from January 1, 2000 to December 31, 2014. Total index hospitalization costs were extracted and presented in 2014 consumer price index inflation adjusted US dollars. Patients were stratified into quartiles (Q) according to IMPACT risk score. Logarithmic transformation normalized cost data, and linear regression assessed for correlation. Comparison of cost between Q of IMPACT risk score was performed using rank-sum and Kruskal-Wallis tests. Survival was estimated using the Kaplan-Meier method. Results: Three hundred fifty six (n= 356) OHTx were performed during the study period. Median IMPACT score for the cohort was five (IQR 3-6) . Eight (2.2%) patients died within 30-days and 1-year Kaplan-Meier survival was 88.3%. Median length of stay was 16 (IQR 14-24) days. Median cost for index admission was $222,200 (IQR:$169,200-$313,700). Median length of stay was longer in Q4 vs Q1 (15d vs 18d, p= 0.01) and index hospital costs in Q4 were significantly higher compared to Q1 patients ($280,400 vs $205,000, p
