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  • Risk Factors of Prolonged I...
    Niewińsk, G.; Raszeja-Wyszomirska, J.; Główczyńska, R.; Figiel, W.; Zając, K.; Kornasiewicz, O.; Zieniewicz, K.; Grąt, M.

    Transplantation proceedings, September 2018, 2018-Sep, 2018-09-00, 20180901, Letnik: 50, Številka: 7
    Journal Article

    Prolonged 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. One 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. Highly 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). Sodium-MELD might be a novel risk factor of prolonged ICU stay in this single-center experience. •Sodium-MELD and its components are associated with moderately prolonged ICU stay after LT.•Only sodium-MELD is associated with highly prolonged ICU stay (≥8 days) after LT.•Pretransplant sodium-MELD ≥ 23 points carries a 75% risk of prolonged postoperative ICU stay.