Prognostic impact of mechanical ventilation after liver transplantation: a national database study - 22/09/14
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.
Le texte complet de cet article est disponible en PDF.Keywords : Graft failure, Liver transplantation, Mechanical ventilation, Medicare, Mortality
Plan
| Data reported here have been supplied by the United Network for Organ Sharing (UNOS) as the contractor for the Organ Procurement and Transplantation Network (OPTN). The interpretation and reporting of these data are the responsibility of the authors and in no way should be seen as an official policy of or interpretation by the OPTN, the US Government, or the National Institutes of Health. |
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| This work was supported in part by grants from the National Institutes of Health/National Institute of Diabetes and Digestive and Kidney Diseases RC1DK086450. |
Vol 208 - N° 4
P. 582-590 - octobre 2014 Retour au numéro
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