解读肝移植后返回手术室后长时间住院的风险因素:不断增加的成本和临床影响
Ayato Obana1, Miho Akabane2, Khalid Mumtaz3
1Comprehensive Transplant Center, Department of Surgery, Ohio State University Wexner Medical Center, Columbus, OH; Department of Hepato-Biliary-Pancreatic and Gastrointestinal Surgery, School of Medicine, International University of Health and Welfare, Chiba, Japan.
Surgery
|December 3, 2025
概括
肝移植后意外返回手术是很常见的,特别是由于出血. 高MELD-Na得分和更长的操作时间预测了更长的住院时间和这些患者的成本增加.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 移植手术 移植手术
- 卫生经济学 卫生经济学
背景情况:
- 肝移植后的非计划性重新手术带来了重大挑战.
- 识别与这些回收程序相关的因素对于改善患者的治疗结果和资源管理至关重要.
研究的目的:
- 为了确定与肝移植接受者的回收程序相关的特征.
- 确定接收后延长停留时间 (LOS) 的预测因素.
- 评估与回收程序相关的医疗保健成本.
主要方法:
- 从2016年到2023年,对914名成年肝移植接受者的回顾性分析.
- 延长的LOS定义为>19天 (第75百分位数).
- 进行了多变量分析和成本分析.
主要成果:
- 回收发生在12.7%的接受者中,主要是出血/血瘤 (67.2%).
- 收回患者的MELD-Na得分更高,移植前TIPS更频繁.
- 较高的MELD-Na得分和较长的运行时间预测了回收后延长的LOS.
- 收回与显著更高的住院费用 (199,438美元与155,780美元) 有关.
结论:
- 独特的患者特征与肝移植后的回收有关.
- MELD-Na得分和运行时间是重新操作后长期LOS的独立预测因素.
- 回收程序显著增加医疗保健成本,强调需要风险分层和资源规划.
相关概念视频
Kidney Transplant II: Surgical Procedure
289
Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living...
289
Esophageal Varices-II: Clinical Features and Management
343
Esophageal varices often manifest as gastrointestinal bleeding episodes, presenting symptoms like hematemesis (vomiting of blood), hematochezia (passing fresh blood via the rectum), and melena (black, tarry stools). Other signs can include weight loss, anorexia, abdominal discomfort, jaundice, pruritus, altered mental status, and muscle cramps.
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
343
Kidney Transplant III: Nursing Management
294
Postoperative Nursing Management for Kidney Transplant PatientsPostoperative nursing management care includes monitoring the surgical site, encouraging early movement, and promoting lung health through breathing exercises. Nurses also administer prescribed medications like H2-blockers, such as famotidine, or proton pump inhibitors, like omeprazole, to help prevent gastrointestinal ulcers and bleeding. Fungal infections in the mouth and bladder can result from immunosuppressive and antibiotic...
294


