| Revue: | Annals of hepatology |
| Base de datos: | PERIÓDICA |
| Número de sistema: | 000413458 |
| ISSN: | 1665-2681 |
| Autores: | Piñero, Federico1 Fauda, Martín1 Quiros, Rodolfo1 Mendizabal, Manuel1 González Campaña, Ariel1 Czerwonko, Demian1 Barreiro, Mariano1 Montal, Silvina1 Silberman, Ezequiel1 Coronel, Matías1 Silva, Marcelo1 Cacheiro, Fernando1 Raffa, Pía1 Andriani, Oscar1 Podestá, Luis G1 |
| Instituciones: | 1Hospital Universitario Austral, Pilar, Buenos Aires. Argentina |
| Año: | 2015 |
| Periodo: | Nov-Dic |
| Volumen: | 14 |
| Número: | 6 |
| Paginación: | 845-855 |
| País: | México |
| Idioma: | Inglés |
| Tipo de documento: | Artículo |
| Enfoque: | Analítico, descriptivo |
| Resumen en inglés | Limited information related to Liver Transplantation (LT) costs in South America exists. Additionally, costs analysis from developed countries may not provide comparable models for those in emerging economies. We sought to evaluate a predictive model of Early Discharge from Hospital after LT (ERDALT = length of hospital stay ≤ 8 days). A predictive model was assessed based on the odds ratios (OR) from a multivariate regression analysis in a cohort of consecutively transplanted adult patients in a single center from Argentina and internally validated with bootstrapping technique. Results. ERDALT was applicable in 34 of 289 patients (11.8%). Variables independently associated with ERDALT were MELD exception points OR 1.9 (P = 0.04), surgery time < 4 h OR 3.8 (P = 0.013), < 5 units of blood products consumption (BPC) OR 3.5 (P = 0.001) and early weaning from mechanical intubation OR 6.3 (P = 0.006). Points in the predictive scoring model were allocated as follows: MELD exception points (absence = 0 points, presence = 1 point), surgery time < 4 h (0-2 points), < 5 units of BPC (0-2 points), and early weaning (0-3 points). Final scores ranged from 0 to 8 points with a c-statistic of 0.83 (95% CI 0.77-0.90; P < 0.0001). Transplant costs were significantly lower in patients with ERDALT (median $23,078 vs. $28,986; P < 0.0001). Neither lower patient and graft survival, nor higher rates of short-term re-hospitalization and acute rejection events after discharge were observed in patients with ERDALT. In conclusion, the ERDALT score identifies patients suitable for early discharge with excellent outcomes after transplantation. This score may provide applicable models particularly for emerging economies |
| Disciplinas: | Medicina |
| Palabras clave: | Cirugía, Gastroenterología, Hospitales, Trasplante de hígado, Estancia, Costo de tratamiento, Alta médica |
| Keyword: | Medicine, Gastroenterology, Hospitals, Surgery, Liver transplantation, Stay, Treatment cost, Patient discharge |
| Texte intégral: | Texto completo (Ver PDF) |
