Taking ACTION: A Prognostic Tool for Pediatric Ventricular Assist Device Mortality


We sought to develop a contemporary risk assessment tool for use in pediatric ventricular assist device (VAD) candidates to estimate risk for mortality on the device using readily available preimplantation clinical data. Training and testing datasets were created from Advanced Cardiac Therapies Improving Outcomes Network (ACTION) registry data on patients supported with a VAD from 2012 to 2021. Potential risk factors for mortality were assessed and incorporated into a simplified risk prediction model utilizing an open-source, gradient-boosted decision tree machine learning library, known as random forest. Predictive performance was assessed by the area under the receiver operating characteristic curve in the testing dataset. Nine significant risk factors were included in the final predictive model which demonstrated excellent discrimination with an area under the curve of 0.95. In addition to providing a framework for establishing pediatric-specific risk profiles, our model can help inform team expectations, guide optimal patient selection, and ultimately improve patient outcomes.

This ACTION study was published in the June 2023 issue of  ASAIO Journal. Congratulations to the authors:

  • Katerina Boucek
  • Anaam Alzubi
  • Farhan Zafar
  • Matthew J. O’Connor
  • Mary Mehegan
  • Deepa Mokshagundam
  • Ryan R. Davies
  • Iki Adachi
  • Angela Lorts
  • David N. Rosenthal

Boucek K, Alzubi A, Zafar F, O’Connor MJ, Mehegan M, Mokshagundam D, Davies RR, Adachi I, Lorts A, Rosenthal DN. Taking ACTION: A Prognostic Tool for Pediatric Ventricular Assist Device Mortality. ASAIO J. 2023 Jun 1;69(6):602-609. doi: 10.1097/MAT.0000000000001899. Epub 2023 May 27. PMID: 37261722.