周末等待列表对美国急性肝衰竭患者的移植相关结果的影响
Melis G Celdir1, Qianyi Shi2, Tomohiro Tanaka3,4
1Division of Gastroenterology Washington University School of Medicine St. Louis Missouri USA.
JGH open : an open access journal of gastroenterology and hepatology
|September 3, 2025
概括
在周末急性肝功能衰竭 (ALF) 之后,将成年患者列为肝移植 (LT) 患者,与更糟糕的结果有关. 这包括较低的自发存活率和增加的LT后死亡率,突出显示了潜在的护理延迟.
科学领域:
- 肝病学
- 移植医学
- 医疗服务研究
背景情况:
- 周末护理的差异可能会影响患者的结果.
- 周末清单对急性肝衰竭 (ALF) 肝移植 (LT) 的影响尚未得到充分研究.
研究的目的:
- 评估在周末等待列表 (WL) 和ALF患者的LT后结果中列出LT的影响.
主要方法:
- 使用UNOS数据库对成年ALF患者进行回顾性队列研究 (2002-2023年).
- 根据上市时间 (周日与周末后) 评估结果.
- 使用回归模型和反向概率审查权重进行分析.
主要成果:
- 在6600名ALF患者中,13%的患者在周末后被列出.
- 周末清单与较低的自发存活率相关 (RR 0. 74).
- 周末列出的患者的1年后LT死亡率更高 (HR 1. 25).
结论:
- 在周末之后进行肝移植与ALF患者的自发存活率较低和移植后死亡率较高有关.
- 调查导致周末护理延误的系统层面因素对于提高移植护理效率至关重要.
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