Salah Manar, Montasser Iman Fawzy, El Gendy Hanaa A, Korraa Alaa A, Elewa Gamal M, Dabbous Hany, Mahfouz Hossam R, Abdelrahman Mostafa, Goda Mohammed Hisham, Bahaa El-Din Mohamed Mohamed, El-Meteini Mahmoud, Labib Heba A
Department of Tropical Medicine, Ain Shams Center for Organ Transplantation, Ain Shams University, Cairo 11566, Egypt.
Department of Anaesthesia and Critical Care, Ain Shams Centre for Organ Transplantation, Ain Shams University, Cairo 11566, Egypt.
World J Hepatol. 2022 Jun 27;14(6):1150-1161. doi: 10.4254/wjh.v14.i6.1150.
Patients who undergo living donor liver transplantation (LDLT) may suffer complications that require intensive care unit (ICU) readmission.
To identify the incidence, causes, and outcomes of ICU readmission after LDLT.
A retrospective cohort study was conducted on patients who underwent LDLT. The collected data included patient demographics, preoperative characteristics, intraoperative details; postoperative stay, complications, causes of ICU readmission, and outcomes. Patients were divided into two groups according to ICU readmission after hospital discharge. Risk factors for ICU readmission were identified in univariate and multivariate analyses.
The present study included 299 patients. Thirty-one (10.4%) patients were readmitted to the ICU after discharge. Patients who were readmitted to the ICU were older in age (53.0 ± 5.1 49.4 ± 8.8, = 0.001) and had a significantly higher percentage of women (29% 13.4%, = 0.032), diabetics (41.9% 24.6%, = 0.039), hypertensives (22.6% 6.3%, = 0.006), and renal (6.5% 0%, = 0.010) patients as well as a significantly longer initial ICU stay (6 4 d, respectively, < 0.001). Logistic regression analysis revealed that significant independent risk factors for ICU readmission included recipient age (OR = 1.048, 95%CI = 1.005-1.094, = 0.030) and length of initial hospital stay (OR = 0.836, 95%CI = 0.789-0.885, < 0.001).
The identification of high-risk patients (older age and shorter initial hospital stay) before ICU discharge may help provide optimal care and tailor follow-up to reduce the rate of ICU readmission.
接受活体肝移植（LDLT）的患者可能会出现需要再次入住重症监护病房（ICU）的并发症。
确定活体肝移植后再次入住重症监护病房的发生率、原因及转归。
对接受活体肝移植的患者进行回顾性队列研究。收集的数据包括患者人口统计学资料、术前特征、术中细节、术后住院时间、并发症、再次入住重症监护病房的原因及转归。根据出院后是否再次入住重症监护病房将患者分为两组。通过单因素和多因素分析确定再次入住重症监护病房的危险因素。
本研究纳入299例患者。31例（10.4%）患者出院后再次入住重症监护病房。再次入住重症监护病房的患者年龄较大（53.0±5.1对49.4±8.8，P = 0.001），女性比例显著更高（29%对13.4%，P = 0.032），糖尿病患者比例显著更高（41.9%对24.6%，P = 0.039），高血压患者比例显著更高（22.6%对6.3%，P = 0.006），肾脏疾病患者比例显著更高（6.5%对0%，P = 0.010），且首次入住重症监护病房的时间显著更长（分别为6天对4天，P<0.001）。Logistic回归分析显示，再次入住重症监护病房的显著独立危险因素包括受者年龄（OR = ）。
在重症监护病房出院前识别高危患者（年龄较大和首次住院时间较短）可能有助于提供最佳护理并调整随访方案，以降低再次入住重症监护病房的发生率。 （注：原文中“OR = 1.048, 95%CI = 1.005-1.094, = 0.030”以及“OR = 0.836, 95%CI = 0.789-0.885, < 0.001”处的“ = ”“<”后面内容缺失，译文按原文呈现）
