Prognostic impact of mechanical ventilation after liver transplantation: a national database study
| Autor: | Janet E. Tuttle-Newhall, Nino Dzebisashvili, Krista L. Lentine, Mark A. Schnitzler, Hui Yuan, Vikram S. Chawa, Huiling Xiao, David A. Axelrod |
|---|---|
| Rok vydání: | 2014 |
| Předmět: |
Adult
Graft Rejection Male medicine.medical_specialty Multivariate analysis Adolescent medicine.medical_treatment Liver transplantation Article Young Adult Risk Factors Internal medicine Ascites medicine Humans Registries Dialysis Retrospective Studies Postoperative Care Mechanical ventilation business.industry Incidence Incidence (epidemiology) Graft Survival Hazard ratio General Medicine Middle Aged Prognosis Respiration Artificial United States Liver Transplantation Surgery Survival Rate Treatment Outcome Female medicine.symptom business Complication Liver Failure Follow-Up Studies |
| Zdroj: | The American Journal of Surgery. 208:582-590 |
| ISSN: | 0002-9610 |
| DOI: | 10.1016/j.amjsurg.2014.06.004 |
| Popis: | The impact of mechanical ventilatory support (MCVS) on mortality and graft loss after liver transplantation (LT) is not well described.Multivariate analysis of a novel database linking national transplant registry and Medicare claims data was used to assess the impact of early MCVS on mortality and graft survival following LTs performed between 2002 and 2008.Among 10,517 LT recipients, 6.9% (n = 726) required postoperative MCVS, 25.6% of whom required less than 96 hours, 24.2% required 96 hours or longer, and 50.1% received an unspecified duration. Significant predictors of prolonged MCVS included older age, female sex, pretransplant dialysis requirement, and ascites. After multivariate adjustment, MCVS of 96 hours or longer was associated with nearly 3 times the adjusted hazard ratio of mortality (2.95, P.001), while MCVS less than 96 hours was not significantly associated with mortality (adjusted hazard ratio .88, P = .55).Recognition of LT patients at risk for prolonged MCVS may help to reduce the incidence and consequences of this complication. |
| Databáze: | OpenAIRE |
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