Exercise Capacity Impairment Can Predict Postoperative Pulmonary Complications after Liver Transplantation
Exercise Capacity Impairment Can Predict Postoperative Pulmonary Complications after Liver Transplantation
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DOI：
10.1159/000479008
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发表时间：
2017-01-01
期刊：
影响因子：
3.7
通讯作者：
Barros Pereira, Eanes Delgado
中科院分区：
文献类型：
--
作者：
de Araujo Magalhaes, Clarissa Bentes;Nogueira, Ingrid Correia;Barros Pereira, Eanes Delgado
背景资料：肝移植术后呼吸系统并发症（PRCs）是肝移植术后常见的并发症，是肝移植术后并发症的主要原因。目的：本文的目的是确定肝移植后PRCs的发生率和简单运动能力测量作为PRCs独立预测因子的价值。研究方法：我们对2013年3月至2015年3月在巴西福塔莱萨的一家大学医院接受LT的连续成人进行了一项前瞻性队列研究。在基线时，采用6分钟步行试验（6 MWT）和6分钟台阶试验（6 MST）评估运动能力，采用肺功能测定法测试肺功能，采用最大呼吸压测量呼吸肌力量。通过访谈和病历审查收集了其他相关术前和术中数据，并评价了其与PRC发生率的相关性。结果：该研究纳入了100例受试者，其中44%的受试者至少有1例PRC。在单变量分析中，较差的6 MST和6 MWT结果以及较长的术前冷缺血时间与PRCs相关。逻辑回归分析显示，当术前步行距离较长时，PRC发生的可能性较小：每步行50 m，比值比（95% CI）降至0.589（0.357-0.971）（p = 0.03）。同样，PRCs更可能发生在术前冷缺血时间较长的患者中：每分钟的比值比（95% CI）增加至1.008（1.002-1.015）（p = 0.01）。结论：肝移植患者PRCs发生率高。在该患者人群中，冷缺血时间延长和术前6 MWT结果是PRC的独立预测因素。(C)2017 S. Karger AG，巴塞尔
Background: Postoperative respiratory complications (PRCs) are common after liver transplantation (LT) and contribute significantly to the related morbidity and mortality. Objective: The aim of this paper was to determine the incidence of PRCs after LT and the value of simple exercise capacity measures as independent predictors of PRCs. Methods: We conducted a prospective cohort study of consecutive adults submitted to LT at a University Hospital in Fortaleza Brazil from March 2013 to March 2015. At baseline, exercise capacity was assessed with the 6-minute walk test (6MWT) and the 6-minute step test (6MST), lung function was tested by spirometry, and respiratory muscle strength was measured by maximal respiratory pressure. Additional relevant pre-and intraoperative data were collected through interview and chart review, and their association with the incidence of PRCs was evaluated. Results: The study included 100 subjects, 44% of whom presented at least 1 of the PRCs. In the univariate analysis, poor 6MST and 6MWT results and a longer preoperative cold ischemia time were associated with PRCs. The logistic regression analysis showed that PRCs were less likely to occur when preoperative walking distances were longer: the odds ratio (95% CI) was reduced to 0.589 (0.357-0.971) for each 50 m walked (p = 0.03). Likewise, PRCs were more likely to occur in patients with longer preoperative cold ischemia times: the odds ratio (95% CI) increased to 1.008 (1.002-1.015) for each minute (p = 0.01). Conclusion: The incidence of PRCs is high in LT patients. A prolonged cold ischemia time and preoperative 6MWT results were independent predictors of PRCs in this patient population. (C) 2017 S. Karger AG, Basel