A Retrospective Study of the Role of Perioperative Serum Albumin and the Albumin-Bilirubin Grade in Predicting Post-Liver Transplant Length of Stay.

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY

Accounts of Chemical Research Pub Date : 2023-03-01 DOI:10.1177/10892532221141138

Ryan Wang, Daniel Katz, Hung-Mo Lin, Yuxia Ouyang, Jonathan Gal, Sumanth Suresh, Ismail Labgaa, Parissa Tabrizian, Samuel Demaria, Jeron Zerillo, Natalie K Smith

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引用次数: 4

Abstract

Introduction: Serum albumin's association with liver transplant outcomes has been investigated with mixed findings. This study aimed to evaluate perioperative albumin level, independently and as part of the albumin-bilirubin (ALBI) grade, as a predictor of post-liver transplant hospital and intensive care unit (ICU) length of stay (LOS).

Methods: Adult liver-only transplant recipients at our institution from September 2011 to May 2019 were included in this retrospective study. Repeat transplants were excluded. Demographic, laboratory, and hospital course data were extracted from an institutional data warehouse. Negative binomial regression was used to assess the association of LOS with ALBI grade, age, BMI, ASA score, Elixhauser comorbidity index, MELD-Na, warm ischemia time, units of platelets and cryoprecipitate transfused, and preoperative serum albumin.

Results: Six hundred and sixty-three liver transplant recipients met inclusion criteria. The median preoperative serum albumin was 3.1 [2.6-3.6] g/dL. The median postoperative ICU and hospital LOS were 3.8 [2.4-6.8] and 12 [8-20] days, respectively. Preoperative serum albumin predicted hospital but not ICU LOS (ratio .9 [95% confidence interval (CI) .84-.99], P = .03, hospital LOS vs ratio .92 [95% CI 0.84-1.02], P = .10, ICU LOS). For patients with MELD-Na ≤ 20, ALBI grade-3 predicted longer hospital and ICU LOS (ratio 1.40 [95% CI 1.18-1.66], P < .001, hospital LOS vs ratio 1.62 [95% CI 1.32-1.99], P < .001, ICU LOS). These associations were not significant for patients with MELD-Na > 20.

Conclusions: Serum albumin predicted post-liver transplant hospital LOS. ALBI grade-3 predicted increased hospital and ICU LOS in low MELD-Na recipients.

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围手术期血清白蛋白及白蛋白-胆红素分级预测肝移植术后住院时间的回顾性研究。

简介:血清白蛋白与肝移植结果的关系已被研究，结果好坏参半。本研究旨在评估围手术期白蛋白水平，作为白蛋白-胆红素(ALBI)分级的一部分，作为肝移植后住院和重症监护病房(ICU)住院时间(LOS)的预测因子。方法:回顾性研究纳入2011年9月至2019年5月在我院接受成人单肝移植的患者。排除重复移植。从机构数据仓库中提取人口统计、实验室和医院病程数据。采用负二项回归评估LOS与ALBI分级、年龄、BMI、ASA评分、Elixhauser合病指数、MELD-Na、热缺血时间、输血小板和冷沉淀单位、术前血清白蛋白的关系。结果:663例肝移植受者符合纳入标准。术前血清白蛋白中位数为3.1 [2.6-3.6]g/dL。术后ICU和医院LOS中位数分别为3.8[2.4-6.8]天和12[8-20]天。术前血清白蛋白预测医院，但不能预测ICU的LOS(比值为0.9)(95%可信区间(CI)为0.84)。[99]， P = .03，医院LOS vs .92 [95% CI 0.84-1.02]， P = .10, ICU LOS)。对于MELD-Na≤20的患者，ALBI 3级预测更长的住院和ICU LOS(比值1.40 [95% CI 1.18-1.66]， P < .001，医院LOS vs比值1.62 [95% CI 1.32-1.99]， P < .001, ICU LOS)。对于MELD-Na > 20的患者，这些关联不显著。结论:血清白蛋白预测肝移植术后医院LOS。ALBI 3级预测低MELD-Na受者的医院和ICU LOS增加。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.