A Multi-Dimensional General Health Status Concept to Predict Liver Transplant Mortality

General health status is a holistic concept that includes not just diseases, but also life expectancy, activities, and health status. However, there is a gap in understanding how recipient general health status impact survival post liver transplantation. We aimed to evaluate the impact of general health status on survival after liver transplantation, while adjusting for severity of their comorbidities and demographics. This was a retrospective cohort study of 344 adults 18 years or older that underwent liver transplantation from 01/01/2008 through 12/31/2014. Predictors were general health status, comorbidities, and demographics. A severity score was built for health status and for each of the comorbidities by body system. The outcome was all-cause mortality after transplantation. Cox proportional hazard models and Kaplan-Meier analysis were used. From 344 patients, 82 died at the end of follow-up time (mean = 609 days), and 262 were alive (mean = 1523 days). General health status score controlled for comorbidities and demographics was statistically significant for mortality (HR = 2.20, p-value < 0.001). Comorbidities represented by severity scores for the circulatory system (HR = 1.89, p-value < 0.001), endocrine system (HR = 2.22, p-value < 0.01), and musculoskeletal system (HR = 2.04, p-value < 0.05) were also statistically significant. Survival analysis showed statistically significant differences between different categories of general health status. This study was the first to use pre-transplant recipient general health status as a single weighed metric to predict survival post-transplant; thus, providing new evidence to evaluate risk of mortality that is individualized for each patient.