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©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
Intensive care unit readmission in adult Egyptian patients undergoing living donor liver transplant: A single-centre retrospective cohort study
Manar Salah, Iman Fawzy Montasser, Hanaa A El Gendy, Alaa A Korraa, Gamal M Elewa, Hany Dabbous, Hossam R Mahfouz, Mostafa Abdelrahman, Mohammed Hisham Goda, Mohamed Mohamed Bahaa El-Din, Mahmoud El-Meteini, Heba A Labib
Manar Salah, Iman Fawzy Montasser, Hany Dabbous, Department of Tropical Medicine, Ain Shams Center for Organ Transplantation, Ain Shams University, Cairo 11566, Egypt
Hanaa A El Gendy, Alaa A Korraa, Gamal M Elewa, Hossam R Mahfouz, Heba A Labib, Department of Anaesthesia and Critical Care, Ain Shams Centre for Organ Transplantation, Ain Shams University, Cairo 11566, Egypt
Mostafa Abdelrahman, Mohammed Hisham Goda, Mohamed Mohamed Bahaa El-Din, Mahmoud El-Meteini, Department of General Surgery and Liver Transplantation, Ain Shams Centre for Organ Transplantation, Ain Shams University, Cairo 11566, Egypt
Author contributions: Korraa AA, Elewa GM, and El Gendy HA designed the research; Montasser IF, Salah M, and Labib HA performed the research, wrote the paper, contributed analytical tools and analysed the data; Abdelrahman M and Goda MH contributed in data collection and analysis; Dabbous H, Bahaa M, and El-Meteini M revised the manuscript; All authors have read and approved the final manuscript.
Institutional review board statement: This study was approved by the Ethics Committee of the Faculty of Medicine, Ain Shams University, Egypt (approval number: IRB/0006379). The confidentiality of the patients’ data was maintained by assigning a code number to each patient.
Clinical trial registration statement: The trial is registered in clinical trial.gov (NCT04067739).
Conflict-of-interest statement: All the authors declare that they have no conflict of interest.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Iman Fawzy Montasser, MD, Professor, Department of Tropical Medicine, Ain Shams Centerfor Organ Transplantation, Ain Shams University, Abbassia Square, Khalifa El Mamoun Street, Cairo 11566, Egypt. imanfawzy2@gmail.com
Received: January 31, 2022
Peer-review started: January 31, 2022
First decision: March 25, 2022
Revised: April 1, 2022
Accepted: June 3, 2022
Article in press: June 3, 2022
Published online: June 27, 2022
BACKGROUND
Patients who undergo living donor liver transplantation (LDLT) may suffer complications that require intensive care unit (ICU) readmission.
AIM
To identify the incidence, causes, and outcomes of ICU readmission after LDLT.
METHODS
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.
RESULTS
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 vs 49.4 ± 8.8, P = 0.001) and had a significantly higher percentage of women (29% vs 13.4%, P = 0.032), diabetics (41.9% vs 24.6%, P = 0.039), hypertensives (22.6% vs 6.3%, P = 0.006), and renal (6.5% vs 0%, P = 0.010) patients as well as a significantly longer initial ICU stay (6 vs 4 d, respectively, P < 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, P = 0.030) and length of initial hospital stay (OR = 0.836, 95%CI = 0.789-0.885, P < 0.001).
CONCLUSION
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.
Core Tip: Patients undergoing living donor liver transplantation may suffer complications that require intensive care unit readmission. We retrospectively evaluated 299 patients who underwent living donor liver transplantation. We identified the incidence, causes, and outcomes of intensive care unit readmission after living donor liver transplantation. Older recipient age and longer length of initial hospital stay were recognized as significant independent risk factors for intensive care unit readmission. The identification of high-risk patients before discharge may help provide optimal care and tailor follow-up to reduce the rate of intensive care unit readmission.
