Delayed referral for liver transplant evaluation worsens outcomes in chronic liver disease patients requiring inpatient transplant evaluation

Table 5 Predictors of death

	Initial multivariate regression				Backward logistic regression
	Wald	P value	OR	95%CI	Wald	P value	OR	95%CI
Age (yrs)	5.51	0.02	1.12	1.0-1.2	6.24	0.01	1.10	1.0-1.1
Education (HS)	0.72	0.40	0.75	0.4-1.5	-	-	-	-
ICU stay (+)	0.03	0.86	0.84	0.1-5.8	-	-	-	-
ACLF grade (G3)	0.06	0.81	1.19	0.3-4.9	-	-	-	-
MELD (points)	4.58	0.03	0.73	0.5-1.0	-	-	-	-
Creatinine (mg/dL)	2.85	0.09	2.46	0.9-7.0	-	-	-	-
Sodium (mmol/L)	5.25	0.02	0.82	0.7-1.0	-	-	-	-
Bilirubin (mg/dL)	0.04	0.84	0.99	0.9-1.1	-	-	-	-
INR	3.06	0.08	8.85	0.8-101	-	-	-	-
WBC (×109/L)	0.02	0.88	1.02	0.8-1.3	-	-	-	-
Hematocrit (%)	1.57	0.21	1.11	0.9-1.3	2.67	0.10	1.09	1.0-1.2
Platelets (×109/L)	0.09	0.76	1.00	1.0-1.0	-	-	-	-
N-L ratio	5.90	0.02	1.22	1.0-1.4	5.47	0.02	1.11	1.0-1.2
Albumin (g/dL)	5.07	0.02	0.18	0.0-0.8	2.67	0.10	0.49	0.2-1.2
Malnutrition (+)	0.04	0.85	0.84	0.1-5.1	-	-	-	-
Cardiac dx (+)	1.71	0.19	3.53	0.5-23	-	-	-	-
Sex (Male)	4.43	0.04	0.08	0.0-0.8	-	-	-	-
Race (White)	1.06	0.30	0.32	0.0-2.8	-	-	-	-
Depression (+)	1.72	0.19	3.07	0.6-16	-	-	-	-
Time since dx (mo)	5.84	0.02	0.97	1.0-1.0	3.52	0.06	0.99	1.0-1.0
Pressor need (+)	0.36	0.55	0.44	0.0-6.5	-	-	-	-
Height (cm)	4.04	0.05	1.13	1.0-1.3	-	-	-	-
Weight (kg)	3.83	0.05	1.04	1.0-1.1	7.01	< 0.01	1.02	1.0-1.0
Transferred (+)	1.53	0.22	0.36	0.1-1.8	-	-	-	-
Refer to LTE (d)	0.65	0.42	0.99	1.0-1.0	-	-	-	-
Delayed referral (+)	6.75	0.01	8.40	1.7- 42	7.27	< 0.01	4.51	1.5-14
Decompensations (#)	3.61	0.06	2.08	1.0-4.4	6.33	0.01	1.49	1.1-2.0
Etiology (ETOH)	1.22	0.27	1.30	0.8-2.1	-	-	-	-
Blood type (A)	4.98	0.03	3.01	1.1-7.9	-	-	-	-
TIPS (+)	0.44	0.51	1.45	0.5-4.4	-	-	-	-
Constant	0.09	0.76	0.02	-	0.75	0.38	6.54	-

Multivariable logistic model with backward logistic regression to identify predictors of receiving transplant in patients undergoing inpatient liver transplant evaluation (LTE). Starting with 30 potential variables that may predict hepatic encephalopathy, backward regression identified 8 potential independent predictors for transplant including age, Hematocrit, N-L ratio, serum albumin, sex, time since diagnosis, weight, number of decompensations, and having a delayed LTE. Regression complete din SPSS using backward regression conditional model; probability to enter 0.05 and probability to remove 0.10. Units recorded in parenthesis for continuous variables; reference variable recorded in parenthesis for categorical variables where “+” indicates the variable is present in the patient. ACLF: Acute on chronic liver failure; ICU: Intensive care unit; WBC: White blood cell count; MELD: Model for end stage liver disease; INR: International normalized ratio; N-L ratio: Neutrophil to lymphocyte ratio; dx: Diagnosis; TIPS: Trans-jugular intrahepatic portosystemic shunt.