Title:Prediction Models and Scores in Adult Congenital Heart Disease
Volume: 27
Issue: 10
Author(s): Alexandra Arvanitaki, Despoina Ntiloudi, George Giannakoulas and Konstantinos Dimopoulos*
Affiliation:
- Adult Congenital Heart Centre and National Centre for Pulmonary Hypertension, Royal Brompton Hospital,United Kingdom
Keywords:
Adult congenital heart disease, prediction model, risk score, morbidity, mortality, arrhythmic events.
Abstract: Nowadays, most patients with congenital heart disease survive to adulthood due to advances in pediatric
cardiac surgery but often present with various comorbidities and long-term complications, posing challenges
in their management. The development and clinical use of risk scores for the prediction of morbidity
and/or mortality in adults with congenital heart disease (ACHD) is fundamental in achieving optimal management
for these patients, including appropriate follow-up frequency, treatment escalation, and timely referral for
invasive procedures or heart transplantation. In comparison with other fields of cardiovascular medicine, there
are relatively few studies that report prediction models developed in the ACHD population, given the small
sample size, heterogeneity of the population, and relatively low event rate. Some studies report risk scores originally
developed in pediatric congenital or non-congenital population, externally validated in ACHD with variable
success. Available risk scores are designed to predict heart failure or arrhythmic events, all-cause mortality,
post-intervention outcomes, infective endocarditis, or atherosclerosis-related cardiovascular disease in
ACHD. A substantial number of these scores are derived from retrospective studies and are not internally or externally
validated. Adequately validated risk scores can be invaluable in clinical practice and an important step
towards personalized medicine. Multicenter collaboration, adequate study design, and the potential use of artificial
intelligence are important elements in the effort to develop reliable risk scores for the ACHD population.
