Alejandro Pita1, Brian Nguyen2, Daisy Rios2, Nicolas Maalouf2, Mary Lo3, Yuri Genyk2, Linda Sher2, J Perren Cobb2. 1. Department of Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States. Electronic address: alejandro.pita@med.usc.edu. 2. Department of Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States. 3. Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States.
Abstract
PURPOSE: Recovery after liver transplant (LT) requires extensive resources, including prolonged intensive care unit stays. The objective of this study was to use an assessment tool to determine if LT recipients remain in ICU beyond designated indications. METHODS: Records from 100 consecutive LTs performed in a single institution were retrospectively reviewed. An admission, discharge, and triage screening (ADT) tool was utilized to assess the indications for each ICU day. Data collected included demographics; pre-, intra-, and post-operative course; and complications. Days not meeting ADT criteria were considered additional ICU days. RESULTS: 100 patients: mean age 55 years (range 24-78 years) and mean MELD score 30 (range 6-47). Three recipients who died within one week were excluded. Forty-eight (49.5%) patients had a total of 75 additional days on initial ICU stay. Univariate analysis revealed no significant differences between patients with and without additional days. 12/97 (12.4%) patients returned to ICU including 5/48 and 7/49 with and without additional days. CONCLUSION: Nearly half of the LT recipients remained in ICU an average of 1.6 additional days. Monitoring of organ function appeared to be the most common reason. Opportunities to improve resource utilization could include transfer to an intermediate/progressive care ("step-down") unit. Published by Elsevier Inc.
PURPOSE: Recovery after liver transplant (LT) requires extensive resources, including prolonged intensive care unit stays. The objective of this study was to use an assessment tool to determine if LT recipients remain in ICU beyond designated indications. METHODS: Records from 100 consecutive LTs performed in a single institution were retrospectively reviewed. An admission, discharge, and triage screening (ADT) tool was utilized to assess the indications for each ICU day. Data collected included demographics; pre-, intra-, and post-operative course; and complications. Days not meeting ADT criteria were considered additional ICU days. RESULTS: 100 patients: mean age 55 years (range 24-78 years) and mean MELD score 30 (range 6-47). Three recipients who died within one week were excluded. Forty-eight (49.5%) patients had a total of 75 additional days on initial ICU stay. Univariate analysis revealed no significant differences between patients with and without additional days. 12/97 (12.4%) patients returned to ICU including 5/48 and 7/49 with and without additional days. CONCLUSION: Nearly half of the LT recipients remained in ICU an average of 1.6 additional days. Monitoring of organ function appeared to be the most common reason. Opportunities to improve resource utilization could include transfer to an intermediate/progressive care ("step-down") unit. Published by Elsevier Inc.
Entities:
Keywords:
ADT screening tool; Additional ICU days; ICU length of stay; Liver transplant recovery; Progressive care unit
Authors: Rachael A Lee; Jason Goldman; Ghady Haidar; Jessica Lewis; Sana Arif; Jonathan Hand; Ricardo M La Hoz; Stephanie Pouch; Eric Holaday; Heather Clauss; Keith S Kaye; Anoma Nellore Journal: Open Forum Infect Dis Date: 2022-01-22 Impact factor: 3.835