Guthrie Healthcare System, Sayre, Pennsylvania.
SUNY Downstate Medical Center, Brooklyn, New York.
Catheter Cardiovasc Interv. 2020 Nov;96(6):E576-E584. doi: 10.1002/ccd.29168. Epub 2020 Jul 29.
Our aim is to describe characteristics of liver transplant patients undergoing percutaneous coronary interventions (PCI) as well as in-hospital outcomes including the mortality and peri-procedural complications from the largest publicly available inpatient database in the United States from 2002 to 2014.
Outcomes of PCI are well studied in patients with end-stage liver disease but not well studied in patients who receive liver transplant (LT).
Data derived from Nationwide Inpatient Sample (NIS) were analyzed for years 2002-2014. Adult Hospitalizations with PCI were identified using ICD-9-CM procedure codes. LT status and various complications were identified by using previously validated ICD-9-CM diagnosis codes. Endpoints were in-hospital mortality and peri-procedural complications. Propensity match analysis was performed to compare the endpoints between two groups.
During the study period, 8,595,836 patients underwent PCI; 4,080 (0.04%) patients had prior LT status. 93% of patients were above age 59 years, 79% were males and 69% were nonwhites. Out of the total patients with LT status, 73% had hypertension, 57% had diabetes mellitus, and 47% had renal failure. Post-PCI complications were studied further in both liver and non-LT patients after 1:1 propensity match which showed the incidence of acute kidney injury (AKI) was higher in LT group (12.3 vs 10.7%, p = .024) but dialysis requiring AKI was similar.
Among the LT recipients undergoing PCI, majority were nonwhite males. Almost more than half of the recipients had diabetes mellitus and renal failure. Incidence of AKI was higher in LT group, but other peri-procedural complications were comparable.
我们旨在描述 2002 年至 2014 年期间，在美国最大的公开住院患者数据库中接受经皮冠状动脉介入治疗（PCI）的肝移植患者的特征以及包括死亡率和围手术期并发症在内的住院期间结局。
终末期肝病患者 PCI 的结局已得到充分研究，但在接受肝移植（LT）的患者中研究甚少。
使用国家住院患者样本（NIS）的数据进行了分析，时间范围为 2002 年至 2014 年。使用 ICD-9-CM 手术代码识别接受 PCI 的成人住院患者。使用先前验证的 ICD-9-CM 诊断代码识别 LT 状态和各种并发症。终点是住院期间死亡率和围手术期并发症。进行倾向匹配分析以比较两组的终点。
在研究期间，8595836 例患者接受了 PCI；4080 例（0.04%）患者有 LT 病史。93%的患者年龄在 59 岁以上，79%为男性，69%为非白人。在有 LT 病史的患者中，73%有高血压，57%有糖尿病，47%有肾功能衰竭。在进行 1:1 倾向匹配后，进一步研究了 LT 患者和非 LT 患者的 PCI 后并发症，结果显示 LT 组急性肾损伤（AKI）的发生率更高（12.3%比 10.7%，p=0.024），但需要透析的 AKI 相似。
在接受 PCI 的 LT 接受者中，大多数是白人男性。几乎一半以上的接受者有糖尿病和肾功能衰竭。LT 组 AKI 的发生率较高，但其他围手术期并发症相似。
