等待时间决定了脆弱性的影响:西班牙多中心前性研究
Lorena Puchades1,2, Julia Herreras1, Ana Ibañez3
1Medical Research Institute Hospital La Fe, Hepatology and Liver Transplantation group, Valencia, Spain.
JHEP reports : innovation in hepatology
|September 28, 2023
概括
虚弱性不能预测肝移植候选人的移植前死亡率等待时间短. 然而,脆弱的患者经历了更长的住院时间和早期移植后并发症的增加.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 移植手术 移植手术
- 老年病的医生 老年病的医生
背景情况:
- 在肝移植候选人中,脆弱性很常见,并且与美国的不良结果有关.
- 关于北美以外的脆弱性影响的数据有限.
- 客观脆弱工具需要在不同的肝移植环境中进行验证.
研究的目的:
- 在欧洲多中心队列中对肝脏脆弱指数 (LFI) 进行外部验证.
- 评估移植前虚弱与移植前和移植后结果的关联.
主要方法:
- 从五个西班牙中心招募212名肝硬化门诊患者 (2018-2020年).
- 使用LFI ≥4.5.5的脆弱性的定义.
- 随访至少6个月,以评估死亡率,住院/ICU,并发症,再移植和心血管事件.
主要成果:
- 21%的患者 (n=45) 虚弱,LFI的中位数为3.9.
- 在调整年龄和MELD-Na.之后,脆弱性没有预测移植前死亡率或退出名单 (HR 1.48,p=0.586).
- 虚弱的患者住院时间更长 (13 vs. 9天,p=0.001) 和早期移植后并发症率更高 (100% vs. 55%,p=0.021).
结论:
- 在肝移植设置中,等待时间很短,脆弱性不会影响移植前死亡率.
- 移植前的脆弱性预测了移植后并发症率的增加和更长的住院时间.
- 需要进一步的研究来证实这些环境中预康复策略的好处.
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