Risk Factors for Reintubation Related to Non-Airway Failure After Liver Transplantation in Intensive Care Unit: Observational Study
The aim of this observational study was to evaluate the risk factors and predictive indexes of reintubation in patients after liver transplantation in the intensive care unit of a university hospital. The time at the intensive care unit, time on mechanical ventilation, use of noninvasive ventilation...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Associação Brasileira de Transplante de Órgãos
2022-02-01
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| Series: | Brazilian Journal of Transplantation |
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| Online Access: | https://bjt.emnuvens.com.br/revista/article/view/425 |
| _version_ | 1828271889028481024 |
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| author | Ana Paula Ragonete dos Anjos Agostini Ilka de Fátima Santana Ferreira Boin Aline Heidemann Rodrigo Marques Tonella Antonio Luis Eiras falcao Ligia dos Santos Roceto Ratti Luciana Castilho de Figueiredo Luiz Claudio Martins |
| author_facet | Ana Paula Ragonete dos Anjos Agostini Ilka de Fátima Santana Ferreira Boin Aline Heidemann Rodrigo Marques Tonella Antonio Luis Eiras falcao Ligia dos Santos Roceto Ratti Luciana Castilho de Figueiredo Luiz Claudio Martins |
| author_sort | Ana Paula Ragonete dos Anjos Agostini |
| collection | DOAJ |
| description | The aim of this observational study was to evaluate the risk factors and predictive indexes of reintubation in patients after liver transplantation in the intensive care unit of a university hospital. The time at the intensive care unit, time on mechanical ventilation, use of noninvasive ventilation, ventilator-associated pneumonia, mortality, sequential organ failure assessment scores (SOFA), simplified acute physiology score (SAPS3), model for end-stage liver disease (MELD), Child-Pugh (CHILD), Acute Physiology and Chronic Health Disease Classification System II (APACHE II), and balance of risk score (BAR) were correlated with reintubation. The following tests were used for the statistical analysis: Kolmogorov-Smirnov, χ2, Student’s t-test, and regression analysis and receiver operating characteristic (ROC) curve. Two hundred and thirtyseven individuals were analyzed. Among them, 38 (16%) were reintubated. The comparative analysis was performed between reintubated and nonreintubated individuals. The variables analyzed – ventilator associated pneumonia, death, mechanical ventilation time, intensive care unit time, noninvasive ventilation use, MELD score, SAPS 3, BAR, and SOFA third days – after liver transplantation were significantly different (p < 0.001). In the multivariate regression analysis, the predictors of reintubation after liver transplantation were ventilator associated pneumonia (odds ratio – OR = 10.6; 95% confidence interval – 95%CI 1.04-108.3; p = 0.04) and BAR (OR = 1.18; 95%CI 1.02-1.36; p = 0.02). The highest ROC curves were SOFA third day, MELD, SAPS 3 and BAR scores through the intersections of the sensitivity and specificity curves > 0.70. High values of the BAR score were considered risk factors for reintubation in this study. SOFA third day showed moderate discriminatory power in predicting reintubation after liver transplantation.
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| first_indexed | 2024-04-13T05:59:00Z |
| format | Article |
| id | doaj.art-dce5f8fd0ac14560b780f81d59e66b18 |
| institution | Directory Open Access Journal |
| issn | 2764-1589 |
| language | English |
| last_indexed | 2024-04-13T05:59:00Z |
| publishDate | 2022-02-01 |
| publisher | Associação Brasileira de Transplante de Órgãos |
| record_format | Article |
| series | Brazilian Journal of Transplantation |
| spelling | doaj.art-dce5f8fd0ac14560b780f81d59e66b182022-12-22T02:59:32ZengAssociação Brasileira de Transplante de ÓrgãosBrazilian Journal of Transplantation2764-15892022-02-01251Risk Factors for Reintubation Related to Non-Airway Failure After Liver Transplantation in Intensive Care Unit: Observational StudyAna Paula Ragonete dos Anjos Agostini0Ilka de Fátima Santana Ferreira Boin1Aline Heidemann2Rodrigo Marques Tonella3Antonio Luis Eiras falcao4Ligia dos Santos Roceto Ratti5Luciana Castilho de Figueiredo6Luiz Claudio Martins7Universidade Estadual de Campinas – Campinas (SP), Brazil.Universidade Estadual de Campinas – Campinas (SP), Brazil.Universidade Estadual de Campinas – Campinas (SP), Brazil.Universidade Federal de Minas Gerais – Belo Horizonte (MG), Brazil. Universidade Estadual de Campinas – Campinas (SP), Brazil.Universidade Estadual de Campinas – Campinas (SP), Brazil.Universidade Estadual de Campinas – Campinas (SP), Brazil.Universidade Estadual de Campinas – Campinas (SP), Brazil.The aim of this observational study was to evaluate the risk factors and predictive indexes of reintubation in patients after liver transplantation in the intensive care unit of a university hospital. The time at the intensive care unit, time on mechanical ventilation, use of noninvasive ventilation, ventilator-associated pneumonia, mortality, sequential organ failure assessment scores (SOFA), simplified acute physiology score (SAPS3), model for end-stage liver disease (MELD), Child-Pugh (CHILD), Acute Physiology and Chronic Health Disease Classification System II (APACHE II), and balance of risk score (BAR) were correlated with reintubation. The following tests were used for the statistical analysis: Kolmogorov-Smirnov, χ2, Student’s t-test, and regression analysis and receiver operating characteristic (ROC) curve. Two hundred and thirtyseven individuals were analyzed. Among them, 38 (16%) were reintubated. The comparative analysis was performed between reintubated and nonreintubated individuals. The variables analyzed – ventilator associated pneumonia, death, mechanical ventilation time, intensive care unit time, noninvasive ventilation use, MELD score, SAPS 3, BAR, and SOFA third days – after liver transplantation were significantly different (p < 0.001). In the multivariate regression analysis, the predictors of reintubation after liver transplantation were ventilator associated pneumonia (odds ratio – OR = 10.6; 95% confidence interval – 95%CI 1.04-108.3; p = 0.04) and BAR (OR = 1.18; 95%CI 1.02-1.36; p = 0.02). The highest ROC curves were SOFA third day, MELD, SAPS 3 and BAR scores through the intersections of the sensitivity and specificity curves > 0.70. High values of the BAR score were considered risk factors for reintubation in this study. SOFA third day showed moderate discriminatory power in predicting reintubation after liver transplantation. https://bjt.emnuvens.com.br/revista/article/view/425Intensive care unit, liver, reintubation, surgery, transplantation |
| spellingShingle | Ana Paula Ragonete dos Anjos Agostini Ilka de Fátima Santana Ferreira Boin Aline Heidemann Rodrigo Marques Tonella Antonio Luis Eiras falcao Ligia dos Santos Roceto Ratti Luciana Castilho de Figueiredo Luiz Claudio Martins Risk Factors for Reintubation Related to Non-Airway Failure After Liver Transplantation in Intensive Care Unit: Observational Study Brazilian Journal of Transplantation Intensive care unit, liver, reintubation, surgery, transplantation |
| title | Risk Factors for Reintubation Related to Non-Airway Failure After Liver Transplantation in Intensive Care Unit: Observational Study |
| title_full | Risk Factors for Reintubation Related to Non-Airway Failure After Liver Transplantation in Intensive Care Unit: Observational Study |
| title_fullStr | Risk Factors for Reintubation Related to Non-Airway Failure After Liver Transplantation in Intensive Care Unit: Observational Study |
| title_full_unstemmed | Risk Factors for Reintubation Related to Non-Airway Failure After Liver Transplantation in Intensive Care Unit: Observational Study |
| title_short | Risk Factors for Reintubation Related to Non-Airway Failure After Liver Transplantation in Intensive Care Unit: Observational Study |
| title_sort | risk factors for reintubation related to non airway failure after liver transplantation in intensive care unit observational study |
| topic | Intensive care unit, liver, reintubation, surgery, transplantation |
| url | https://bjt.emnuvens.com.br/revista/article/view/425 |
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