Clinical value and limitations of the preoperative C-reactive-protein-to-albumin ratio in predicting post-operative morbidity and mortality after deceased-donor liver transplantation: a retrospective single-centre study
| Autor: | David Erren, Anna Mantas, Tom Florian Ulmer, Zoltan Czigany, Joerg Boecker, Philipp Bruners, I. Amygdalos, Wen-Jia Liu, Pavel Strnad, Jan Bednarsch, F. Meister, Decan Jiang, Sven Arke Lang, Ulf P. Neumann |
|---|---|
| Přispěvatelé: | Surgery, RS: FHML non-thematic output |
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment morbidity Liver transplantation Logistic regression ALLOCATION PROTEIN/ALBUMIN RATIO INFLAMMATION Risk Factors orthotopic liver transplantation Albumins Internal medicine SCORE Living Donors medicine Humans albumin graft loss Retrospective Studies Transplantation Deceased donor OUTCOMES Receiver operating characteristic biology business.industry C-reactive protein Albumin Perioperative CANCER Liver Transplantation MODEL C-Reactive Protein biology.protein outcome SURVIVAL Complication business CRP EARLY ALLOGRAFT DYSFUNCTION |
| Zdroj: | Transplant International, 34(8), 1468-1480. Wiley |
| ISSN: | 1432-2277 0934-0874 |
| Popis: | Liver transplantation is still associated with a high risk of severe complications and post-operative mortality. This study examines the predictive value of the preoperative C-reactive-protein-to-albumin ratio (CAR) regarding perioperative morbidity and mortality in deceased-donor liver transplantation (DDLT) recipients. In total, 390 DDLT recipients between 05/2010 and 03/2020 were eligible. Predictive abilities of CAR were examined through receiver operating characteristic curve (ROC) analyses. Groups were compared using parametric and non-parametric tests as appropriate. Independent risk factors for morbidity and mortality were identified using uni- and multivariable logistic regression analyses. A good predictive ability for CAR was shown regarding perioperative morbidity (comprehensive complication index >= 75, Clavien-Dindo score >= 4a) and 12-month mortality, with an ideal cut-off of CAR = 26%. Patients with CAR>26% had significantly higher median CCI scores (60 vs. 43, P < 0.001), longer intensive care unit (ICU, 5 vs. 4 days, P < 0.001) and hospital (28 vs. 21 days, P < 0.001) stays and higher 12-month mortality rates (20% vs 6%, P < 0.001). Multivariable analyses identified CAR>26%, pre-OLT inpatient hospitalization (including ICU) and post-operative red blood cell transfusions as independent predictors of severe cumulative morbidity (CCI >= 75). Preoperative CAR might be a reliable additional tool to predict perioperative morbidity and mortality in DDLT recipients. |
| Databáze: | OpenAIRE |
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