Mortality Predictors After Liver Transplant in the Intensive Care Unit

The goal of this study was to evaluate the predictive factors of mortality in patients after liver transplantation in an intensive care unit from the University Hospital. This observational study was conducted by using a database analysis of University Hospital. The sample consisted of patients afte...

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Published in:Transplantation proceedings 2018-06, Vol.50 (5), p.1424-1427
Main Authors: Ragonete dos Anjos Agostini, A.P., de Fatima Santana Boin, I., Martins Tonella, R., Heidemann dos Santos, A.M., Eiras Falcão, A.L., Muterli Logato, C., dos Santos Roceto Ratti, L., Castilho de Figueiredo, L., Martins, L.C.
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Language:English
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Summary:The goal of this study was to evaluate the predictive factors of mortality in patients after liver transplantation in an intensive care unit from the University Hospital. This observational study was conducted by using a database analysis of University Hospital. The sample consisted of patients after liver transplantation registered in the database. The study variables of Sequential Organ Failure Assessment score, Acute Physiology and Chronic Health Disease Classification II (APACHE II), Model for End-Stage Liver Disease, and Child-Pugh scores, and the days of hospitalization in intensive care unit, mechanical ventilation time, and reintubation rate, were correlated. Statistical analysis was performed by using the χ2 test or Fisher exact test, the Mann-Whitney test, and logistic regression analysis. Fifty-eight individuals were analyzed. In the death group, the days of hospitalization in the intensive care unit were within 12 ± 14 days, the time of mechanical ventilation was 180 ± 148 hours, the APACHE II value was 17.6 ± 7.3, the Sequential Organ Failure Assessment score was 8.2 ± 2.7, and reintubation was 40%. In the multivariate regression, the predictive indexes of mortality were the mortality given by APACHE II (odds ratio, 1.1; CI, 1.03–1.17; P = .004), mechanical ventilation time (odds ratio, 1.02; CI, 1.01–1.04; P = .001), and reintubation (odds ratio, 9.06; CI, 1.83–44.9; P = .007). An increase of 1 unit in APACHE II mortality increases the risk of death by 10.2%, and each hour of mechanical ventilation increases the risk of death by 2.6%. The time of mechanical ventilation, orotracheal reintubation, and the mortality given by APACHE II were the variables that best predicted death in this study. •The literature is sparse reporting on factors or predictors of mortality in intensive care units after liver transplantation.•The research may help in the weaning of mechanical ventilation and multidisciplinary intensive care after liver transplantation.•The research shows the need for protocols for weaning and extubation of the patient after the transplant procedure, and there are no studies that report specific protocols for this research group.•Given the main factors and scores that can best predict mortality, the team and care planning could be differentiated in an attempt to reduce mortality after liver transplantation.
ISSN:0041-1345
1873-2623
DOI:10.1016/j.transproceed.2018.02.087