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Differential effect of body mass index on pediatric heart transplant outcomes based on diagnosis
Author(s) -
Godown Justin,
Donohue Janet E.,
Yu Sunkyung,
FriedlandLittle Joshua M.,
Gajarski Robert J.,
Schumacher Kurt R.
Publication year - 2014
Publication title -
pediatric transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.457
H-Index - 69
eISSN - 1399-3046
pISSN - 1397-3142
DOI - 10.1111/petr.12352
Subject(s) - medicine , body mass index , percentile , logistic regression , proportional hazards model , risk of mortality , hazard ratio , demography , pediatrics , confidence interval , statistics , mathematics , sociology
The impact of nutritional status on HT x waitlist mortality in children is unknown, and there are conflicting data regarding the role of nutrition in post‐ HT x survival. This study examined the influence of nutrition on waitlist and post‐ HT x outcomes in children. Children 2–18 yr listed for HT x from 1997 to 2011 were identified from the OPTN database and stratified by BMI percentile. Multivariable logistic regression evaluated the influence of BMI on waitlist mortality. Cox proportional hazard regression assessed the impact of BMI on post‐ HT x mortality. When all 2712 patients were analyzed, BMI did not impact waitlist, one‐, or five‐yr mortality. However, when stratified by diagnosis, BMI > 95% ( AOR 1.96; 95% CI 1.24, 3.09) and BMI < 1% ( AOR 2.17; 95% CI 1.28, 3.68) were independent risk factors for waitlist mortality in patients with CM. BMI did not impact waitlist mortality in CHD and did not impact post‐ HT x outcomes, regardless of diagnosis. BMI > 95% and BMI < 1% are independent risk factors for waitlist mortality in patients with CM, but not CHD . This suggests differing risk factors based on disease etiology, and an individualized approach to risk assessment based on diagnosis may be warranted.