High early cardiovascular mortality after liver transplantation.
High early cardiovascular mortality after liver transplantation.
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DOI：
10.1002/lt.23950
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发表时间：
2014-11
影响因子：
4.6
通讯作者：
Lloyd-Jones, Donald M.
中科院分区：
文献类型：
--
作者：
VanWagner, Lisa B.;Lapin, Brittany;Levitsky, Josh;Wilkins, John T.;Abecassis, Michael M.;Skaro, Anton I.;Lloyd-Jones, Donald M.
心血管疾病（CVD）导致肝移植（LT）后长期死亡率过高，但目前对术后早期CVD死亡率知之甚少。此外，没有模型可以预测各中心的术后早期CVD死亡率。我们分析了2002年2月至2012年12月期间器官获取和移植网络（OPTN）数据库中的成人直接LT接受者，以评估早期（30天）CVD死亡率的患病率和预测因素，CVD死亡率定义为心律失常、心力衰竭、心肌梗死、心脏骤停、血栓栓塞和/或卒中死亡。我们进行了逐步选择的逻辑回归，以建立早期CVD死亡率的预测模型。将性别和中心体积强制纳入最终模型，并使用自举技术进行验证。在54，697例LT接受者中，有1576例（2.9%）在30天内死亡。CVD死亡是30天死亡的主要原因（42.1%），其次是感染（27.9%）和移植失败（12.2%）。在多变量分析中，确定了9个（6个受体，2个供体，1个手术）显著协变量：年龄，术前住院，ICU和呼吸机状态，计算的MELD评分，门静脉血栓形成，国家器官共享，供体BMI和冷缺血时间。该模型显示出中度区分（c-统计量0.66，95% CI：0.63-0.68）。我们提供了第一个多中心预测模型，用于预测早期LT后CVD死亡，这是当前移植时代早期LT后死亡的最常见原因。然而，需要评价OPTN未收集的其他CVD相关变量，以提高模型准确性和潜在的临床实用性。
Cardiovascular disease (CVD) contributes to excess long-term mortality after liver transplantation (LT), however little is known about early post-operative CVD mortality in the current era. In addition, there is no model to predict early post-operative CVD mortality across centers. We analyzed adult recipients of primary LT in the Organ Procurement and Transplantation Network (OPTN) database between February 2002 and December 2012 to assess prevalence and predictors of early (30-day) CVD mortality, defined as death from arrhythmia, heart failure, myocardial infarction, cardiac arrest, thromboembolism, and/or stroke. We performed logistic regression with stepwise selection to develop a predictive model of early CVD mortality. Sex and center volume were forced into the final model, which was validated using bootstrapping techniques. Among 54,697 LT recipients, there were 1576 (2.9%) deaths within 30 days. CVD death was the leading cause of 30-day mortality (42.1%), followed by infection (27.9%) and graft failure (12.2%). In multivariate analysis, 9 (6 recipient, 2 donor, 1 operative) significant covariates were identified: age, pre-operative hospitalization, ICU and ventilator status, calculated MELD score, portal vein thrombosis, national organ sharing, donor BMI and cold ischemia time. The model showed moderate discrimination (c-statistic 0.66, 95% CI: 0.63–0.68). We provide the first multicenter prognostic model for the prediction of early post-LT CVD death, the most common cause of early post-LT mortality in the current transplant era. However, evaluation of additional CVD-related variables not collected by the OPTN are needed in order to improve model accuracy and potential clinical utility.
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影响因子：
37.8
作者：
Go AS;Mozaffarian D;Roger VL;Benjamin EJ;Berry JD;Blaha MJ;Dai S;Ford ES;Fox CS;Franco S;Fullerton HJ;Gillespie C;Hailpern SM;Heit JA;Howard VJ;Huffman MD;Judd SE;Kissela BM;Kittner SJ;Lackland DT;Lichtman JH;Lisabeth LD;Mackey RH;Magid DJ;Marcus GM;Marelli A;Matchar DB;McGuire DK;Mohler ER 3rd;Moy CS;Mussolino ME;Neumar RW;Nichol G;Pandey DK;Paynter NP;Reeves MJ;Sorlie PD;Stein J;Towfighi A;Turan TN;Virani SS;Wong ND;Woo D;Turner MB;American Heart Association Statistics Committee and Stroke Statistics Subcommittee
通讯作者：
American Heart Association Statistics Committee and Stroke Statistics Subcommittee
影响因子：
24
作者：
Lentine, Krista L.;Costa, Salvatore P.;Eagle, Kim A.
通讯作者：
Eagle, Kim A.
影响因子：
6.2
作者：
Gaynor, Jeffrey J.;Moon, Jang I.;Tzakis, Andreas G.
通讯作者：
Tzakis, Andreas G.
影响因子：
120.7
作者：
LEGALL, JR;LEMESHOW, S;SAULNIER, F
通讯作者：
SAULNIER, F
DOI：
10.1016/j.annfar.2011.06.014
发表时间：
2011-12-01
影响因子：
--
作者：
Jung, B.;Cisse, M.;Jaber, S.
通讯作者：
Jaber, S.