TY - JOUR
T1 - Hospital length of stay after lung transplantation
T2 - Independent predictors and association with early and late survival
AU - Banga, Amit
AU - Mohanka, Manish
AU - Mullins, Jessica
AU - Bollineni, Srinivas
AU - Kaza, Vaidehi
AU - Ring, Steve
AU - Bajona, Pietro
AU - Peltz, Matthias
AU - Wait, Michael
AU - Torres, Fernando
PY - 2016
Y1 - 2016
N2 - Background: Duration of index hospitalization after lung transplantation (LTx) is an important variable that has not received much attention. We sought to determine independent predictors of prolonged hospital length of stay (LOS) and its association with early and late outcomes. Methods: The United Network of Organ Sharing database was queried for adult patients undergoing LTx between 2006 and 2014 (N = 14,320). Patients with dual organ or previous transplantation and patients who died during the first 25 days after LTx were excluded (n = 12,647, mean age 55.2 years ± 13.1). Primary outcome was prolonged LOS (>25 days) (3,251/12,647; 25.7%). Donor, recipient, and procedure-related variables were analyzed as potential predictors of prolonged LOS. Association of prolonged LOS with 1-year and 5-year survival was evaluated using Cox proportional hazards analysis. Results: Independent predictors of prolonged LOS included serum albumin, lung allocation score, functional status, and need of extracorporeal membrane oxygenation or ventilator support at the time of transplant; donor age >40 years; gender mismatch (female donor to male recipient); donor body mass index; African American ethnicity; ischemic time >6 hours; and double LTx. Prolonged LOS was independently associated with increased mortality at 1 year (hazard ratio, 3.96; 95% confidence interval, 3.48-4.50; . p < 0.001) and 5 years (hazard ratio, 2.00; 95% confidence interval, 1.79-2.25; . p < 0.001). Conclusions: A significant proportion of patients have a prolonged LOS after LTx, and several recipient, donor, and procedure-related variables are independent predictors of this outcome. Patients with prolonged LOS after LTx have significantly increased risk of death at 1 year and 5 years.
AB - Background: Duration of index hospitalization after lung transplantation (LTx) is an important variable that has not received much attention. We sought to determine independent predictors of prolonged hospital length of stay (LOS) and its association with early and late outcomes. Methods: The United Network of Organ Sharing database was queried for adult patients undergoing LTx between 2006 and 2014 (N = 14,320). Patients with dual organ or previous transplantation and patients who died during the first 25 days after LTx were excluded (n = 12,647, mean age 55.2 years ± 13.1). Primary outcome was prolonged LOS (>25 days) (3,251/12,647; 25.7%). Donor, recipient, and procedure-related variables were analyzed as potential predictors of prolonged LOS. Association of prolonged LOS with 1-year and 5-year survival was evaluated using Cox proportional hazards analysis. Results: Independent predictors of prolonged LOS included serum albumin, lung allocation score, functional status, and need of extracorporeal membrane oxygenation or ventilator support at the time of transplant; donor age >40 years; gender mismatch (female donor to male recipient); donor body mass index; African American ethnicity; ischemic time >6 hours; and double LTx. Prolonged LOS was independently associated with increased mortality at 1 year (hazard ratio, 3.96; 95% confidence interval, 3.48-4.50; . p < 0.001) and 5 years (hazard ratio, 2.00; 95% confidence interval, 1.79-2.25; . p < 0.001). Conclusions: A significant proportion of patients have a prolonged LOS after LTx, and several recipient, donor, and procedure-related variables are independent predictors of this outcome. Patients with prolonged LOS after LTx have significantly increased risk of death at 1 year and 5 years.
KW - 1-year survival
KW - 5-year survival
KW - Donor demographics
KW - Ischemic time
KW - Length of stay
KW - Lung allocation score
KW - Prolonged hospitalization
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U2 - 10.1016/j.healun.2016.07.020
DO - 10.1016/j.healun.2016.07.020
M3 - Article
C2 - 27642060
AN - SCOPUS:84994536710
SN - 1053-2498
JO - Journal of Heart and Lung Transplantation
JF - Journal of Heart and Lung Transplantation
ER -