Retrospective Cohort Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Jun 27, 2022; 14(6): 1150-1161
Published online Jun 27, 2022. doi: 10.4254/wjh.v14.i6.1150
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
Processing time: 143 Days and 0.4 Hours
ARTICLE HIGHLIGHTS
Research background

Intensive care unit (ICU) admission and readmission following liver transplantation is important field in liver transplantation operation. Readmission causes and effect on prognosis in terms of morbidity and mortality are still needed to be further investigated

Research motivation

To identify causes and outcome in recipients post living donor liver transplantation (LDLT) who required ICU readmission after initial discharge from ICU and to compare them with patients who did not require readmission

Research objectives

A retrospective cohort study carried on recipients who had LDLT in single Egyptian center in the period betwenn 2008 and 2018. Patients were divided into two groups according to ICU readmission after initial hospital discharge. Risk factors for ICU readmission were identified in univariate and multivariate analyses.

Research methods

Retrospective cohort study was conducted by reviewing the hospital files and records of adult patients who underwent LDLT at Ain Shams University Hospital, Cairo, Egypt, during the period from January 1, 2008, to December 31, 2018. Causes and outcome of ICU readmission were compared between both groups (Readmission group and non readmission group). Risk factors for ICU readmission were also assessed including donor and recipient factors. Binomial logistic regression was conducted to identify independent risk factors for ICU readmission, including all variables with a P value < 0.1 in univariant analysis.

Research results

Thirty-one (10.4%) patients were readmitted into the ICU within ≤ 3 mo of initial ICU discharge, among whom 7 (2.3% of total cases) had more than one ICU readmission. Biliary complication and sepsis was the most common cause of ICU readmission. Significant independent risk factors included recipient age and length of initial hospital stay after discharge from the ICU.

Research conclusions

The study concluded that older recipient age and duration of hospital stay (word stay) before ICU readmission were significant risk factors for ICU readmission. The overall survival rate for ICU readmitted patients was significantly lower than that for non-ICU readmitted patients.

Research perspectives

Further study are warranted to identity how to improve management of the risky patients and hence improve their survival.