Hui Yuan1, Janet E Tuttle-Newhall2, Vikram Chawa1, Mark A Schnitzler3, Huiling Xiao4, David Axelrod5, Nino Dzebisashvili5, Krista L Lentine6. 1. Department of Anesthesia, Saint Louis University School of Medicine, St. Louis, MO, USA. 2. Department of Anesthesia, Saint Louis University School of Medicine, St. Louis, MO, USA; Department of Surgery, Saint Louis University School of Medicine, St. Louis, MO, USA. 3. Department of Surgery, Saint Louis University School of Medicine, St. Louis, MO, USA; Center for Outcomes Research, Saint Louis University School of Medicine, St. Louis, MO, USA. 4. Center for Outcomes Research, Saint Louis University School of Medicine, St. Louis, MO, USA. 5. Department of Surgery, Dartmouth Hitchcock Medical Center, Hanover, NH, USA. 6. Department of Surgery, Saint Louis University School of Medicine, St. Louis, MO, USA; Department of Surgery, Dartmouth Hitchcock Medical Center, Hanover, NH, USA. Electronic address: lentinek@slu.edu.
Abstract
BACKGROUND: The impact of mechanical ventilatory support (MCVS) on mortality and graft loss after liver transplantation (LT) is not well described. METHODS: 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. RESULTS: 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). CONCLUSIONS: Recognition of LT patients at risk for prolonged MCVS may help to reduce the incidence and consequences of this complication.
BACKGROUND: The impact of mechanical ventilatory support (MCVS) on mortality and graft loss after liver transplantation (LT) is not well described. METHODS: 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. RESULTS: 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). CONCLUSIONS: Recognition of LT patients at risk for prolonged MCVS may help to reduce the incidence and consequences of this complication.
Authors: Richard Ruiz; Hiroko Kunitake; Alan H Wilkinson; Gabriel M Danovitch; Douglas G Farmer; Rafik M Ghobrial; Hasan Yersiz; Jonathan R Hiatt; Ronald W Busuttil Journal: Arch Surg Date: 2006-08
Authors: Paolo R Salvalaggio; Nino Dzebisashvili; Kara E MacLeod; Krista L Lentine; Adrian Gheorghian; Mark A Schnitzler; Samuel Hohmann; Dorry L Segev; Sommer E Gentry; David A Axelrod Journal: Liver Transpl Date: 2011-03 Impact factor: 5.799
Authors: S Feng; N P Goodrich; J L Bragg-Gresham; D M Dykstra; J D Punch; M A DebRoy; S M Greenstein; R M Merion Journal: Am J Transplant Date: 2006-04 Impact factor: 8.086
Authors: Russell Wiesner; Erick Edwards; Richard Freeman; Ann Harper; Ray Kim; Patrick Kamath; Walter Kremers; John Lake; Todd Howard; Robert M Merion; Robert A Wolfe; Ruud Krom Journal: Gastroenterology Date: 2003-01 Impact factor: 22.682
Authors: Robert G Johnson; Ahsan M Arozullah; Leigh Neumayer; William G Henderson; Patrick Hosokawa; Shukri F Khuri Journal: J Am Coll Surg Date: 2007-06 Impact factor: 6.113
Authors: Sven H Loosen; Hans H Bock; Martin Hellmich; Wolfram T Knoefel; Christian Trautwein; Verena Keitel; Johannes G Bode; Ulf P Neumann; Tom Luedde Journal: Dtsch Arztebl Int Date: 2021-07-26 Impact factor: 5.594
Authors: Ryan C Graham; Weston J Bush; Jeffrey S Mella; Jonathan A Fridell; Burcin Ekser; Plamen Mihaylov; Chandrashekhar A Kubal; Richard S Mangus Journal: Ann Transplant Date: 2020-08-11 Impact factor: 1.530
Authors: Dennis Danforth; Rodney A Gabriel; Anthony I Clark; Beverly Newhouse; Swapnil Khoche; Sanjana Vig; Ramon Sanchez; Ulrich H Schmidt Journal: Korean J Anesthesiol Date: 2019-08-03