Risk Factors of Prolonged ICU Stay in Liver Transplant Recipients in a Single-Center Experience |
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Authors: | G Niewińsk J Raszeja-Wyszomirska R G?ówczyńska W Figiel K Zaj?c O Kornasiewicz K Zieniewicz M Gr?t |
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Institution: | 1. II Department of Anaesthesiology and Intensive Care, Medical University of Warsaw, Warsaw, Poland;2. Liver and Internal Medicine Unit, Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland;3. 1st Department of Cardiology, Medical University of Warsaw, Warsaw, Poland;4. Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland |
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Abstract: | BackgroundProlonged initial intensive care unit (ICU) stay after liver transplantation (LT) is associated with prolonged total hospitalization, increased hospital mortality, and impaired patient and graft survival. Recent data suggested that model for end-stage liver disease (MELD) score at the time of LT and the length of surgery were the two independent risk factors for an ICU stay longer than 3 days after LT. We further identified factors influencing prolonged ICU stay in single-center liver graft recipients.Patients and methodsOne hundred fifty consecutive LT recipients (M/F 94/56, median age 55 (range, 39–60), 36% with viral hepatitis, were prospectively enrolled into the study. Associations between clinical factors and prolonged ICU stay were evaluated using logistic regression models. Receiver operating characteristic curves were analyzed to determine the appropriate cutoffs for continuous variables. Threshold for significance was P ≤ .05.ResultsHighly prolonged (≥8 days) and moderately prolonged (≥6 days) postoperative ICU stay was noted in 19 (12.7%) and 59 (39.3%) patients, respectively. Serum bilirubin (P = .001) and creatinine concentrations (P = .011), international normalized ratio (P = .004), and sodium-MELD (P < .001) were all significantly associated with postoperative intensive care unit stay over or equal to 75th percentile (6 days). Sodium-MELD was significantly associated with postoperative care unit stay greater or equal to the 90th percentile (8 days; P = .018).ConclusionsSodium-MELD might be a novel risk factor of prolonged ICU stay in this single-center experience. |
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Keywords: | Address correspondence to Joanna Raszeja-Wyszomirska MD PhD Liver and Internal Medicine Unit Medical University of Warsaw Banacha 1A str 02-097 Warsaw Poland Tel/fax: +48 22 599 16-62 63 |
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