Cylex Scores May Predict Risk for Infection in the First Year Following Heart Transplantation

Abstract

Purpose The average Cylex score (CS) is lower in heart transplant (HTx) patients (pts) prior to infectious episodes, but the impact of a change in CS on the risk of subsequent infection is not known. The purpose of this study was to determine if a change in CS in HTx pts would impact the risk of subsequent infections. Methods and Materials We evaluated 1,567 pairs of CS from 331 HTx pts in their 1st yr. CS Results The risk of future infection was highest in pts in Group 2 (normal to low CS) at 12.5% and lowest in Group 4 (normal to normal CS) at 4.7%. Group A pts (subsequent low CS) had a 47% higher rate of infection than Group B pts (subsequent normal CS; 9.2% vs 4.9%, p=0.001). Infections were viral (n= 14), bacterial (n= 14), fungal (n= 12), parasitic (n=2), and other (n= 5). Average time to infection for Groups A and B were similar (18 ± 23 days vs 26 ± 23 days, p=0.116). Conclusions Maintaining CS > 200 is associated with a 47% reduction in infection risk compared to CS 200 may prevent infections in HTx pts. Further study is needed to confirm these findings. Cylex Group Any-Treated Infection Group A 52/566 (9.2%) Group 1, n (%) (Cylex 22/326 (6.8%) Group 2, n (%) (Cylex ≥ 200, Cylex 30/240 (12.5%) Group B 49/1,001 (4.9%) Group 3, n (%) (Cylex 12/216 (5.5%) Group 4, n (%) (Cylex ≥ 200, Cylex ≥ 200) 37/785 (4.7%) P-value (Group A vs Group B) 0.001