Resources Utilization After Liver Transplantation in Patients With and Without Hepatopulmonary Syndrome: Cleveland Clinic Experience
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Published on: January 13, 2023
Jacek B Cywinski1, Natalya Makarova2, Andrea Arney3
1Department of General Anesthesiology and Outcomes Research, Cleveland Clinic, Cleveland, OH.
Abstract:
Patients with hepatopulmonary syndrome (HPS) reportedly experience posttransplant morbidity and require more resources to care during perioperative period. The exact incremental increase of resources utilization compared with non-HPS population remains unknown.
Methods:
In this single-center retrospective investigation, we compared the perioperative resources utilization of HPS patients undergoing orthotopic liver transplant (n = 28) to cohort without HPS (n = 739). Potential confounding variables were adjusted in the analysis and the multivariable log-linear regression were used.
Results:
The overall hospital costs for HPS patients were about 27% higher compared with non-HPS patients (the ratio of geometric means, 1.27; 98.3% confidence interval, 1.09-1.47; P < 0). HPS diagnosis was independently associated with both longer intensive care unit stay (P < 0.001) and hospital stay (P < 0.001). The odds of being discharged to extended care facility were about 15 times higher for HPS patients comparing to non-HPS patients (odds ratio, 14.9; 97.5% confidence interval, 4.98-44.29; P < 0.001). There were no differences observed in odds of being readmitted to the hospital within 6 mo after the transplant (P = 0.75).
Conclusions:
HPS diagnosis was associated with longer intensive care unit stay, hospital stay, and increased hospital cost, together with higher odds of being discharged to extended care facility compared with non-HPS patients.
