Association between diverticular disease requiring surgical intervention and mortality in the postlung transplant population ‐ a retrospective cohort study
| Autor: | Erin M. Lowery, Katherine A Young, Oh Jin Kwon, William Adams, L.K. Tague, E. Mahoney |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Graft Rejection
Lung Diseases Male medicine.medical_specialty Cystic Fibrosis medicine.medical_treatment Population Disease 030230 surgery Risk Assessment Cystic fibrosis Article 03 medical and health sciences 0302 clinical medicine Risk Factors alpha 1-Antitrypsin Deficiency Internal medicine medicine Humans Lung transplantation education Diverticulitis Aged Proportional Hazards Models Retrospective Studies Immunosuppression Therapy Transplantation education.field_of_study Proportional hazards model business.industry Graft Survival digestive oral and skin physiology Retrospective cohort study Middle Aged medicine.disease Treatment Outcome surgical procedures operative Diverticular disease Female 030211 gastroenterology & hepatology business Lung Transplantation |
| Zdroj: | Transpl Int |
| ISSN: | 1432-2277 0934-0874 |
| Popis: | BACKGROUND: Lung Transplant recipients are at increased risk of complicated diverticular disease. We aim to assess the rate of diverticular surgery in a post-lung transplantation population and identify risk factors for surgery. METHODS: We performed a retrospective cohort study of lung transplant recipients from 2007–2011. Demographic variables were evaluated with the Mann Whitney U and chi-squared tests. Cox regression was performed to evaluate 1- and 2-yr landmark survival, assess predictor variables of diverticular surgery and evaluate impact of surgery on CLAD development. RESULTS: 17 of 158 patients (10.7%) underwent diverticular-related surgery. Surgical patients had significantly worse survival than nonsurgical patients at 1yr [aHR 2.93 (1.05–8.21), p = 0.041] and 2yr [aHR 4.17 (1.26–13.84), p=0.020] landmark analyses. Transplant indication of alpha-1 antitrypsin disease and cystic fibrosis were significantly associated with the need for diverticular surgery. Emergent surgery was associated with poorer survival [aHR 5.12(1.00–26.27), p=0.050]. CONCLUSIONS: Lung transplant patients requiring surgery for complicated diverticular disease have significantly poorer survival than those who do not require surgery. Surgery was more common in patients transplanted for A1AT and CF. Optimal assessment and risk stratification of diverticular disease is necessary to prevent excessive morbidity and mortality following transplantation. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Plný text